NRECA Group Term Life and AD&D Insurance Plan · provisions of the NRECA Group Term Life and AD&D Insurance Plan (referred to as the “Plan” in this document) for OZARK BORDER

NRECA Group Term Life and AD&D Insurance Plan ___________________________________________________________________________

SUMMARY PLAN DESCRIPTION

For:

OZARK BORDER ELECTRIC COOPERATIVE

01-26033-003

EFFECTIVE DATE: January 1, 2012

Introduction

This document is a Summary Plan Description (SPD) providing you with a summary of the key provisions of the NRECA Group Term Life and AD&D Insurance Plan (referred to as the “Plan” in this document) for OZARK BORDER ELECTRIC COOPERATIVE. This Plan is a component plan of the NRECA Group Benefits Program. In the pages that follow, you will find information on the benefits provided by the Plan.

Each participant in this Plan is responsible for reading this SPD and related materials completely and complying with all rules and Plan provisions.

If the terms of this SPD conflict with the terms of the governing plan document, then the terms of the governing plan document will control, rather than this SPD.

Table of Contents

Chapter 1: Contacts ...................................................................................................................................... 6

Chapter 2: Benefit Highlights Under the Plan ......................................................................................... 6

Basic Life Insurance Benefit Highlights ................................................................................ 6

Supplemental Life Insurance Benefit Highlights ................................................................. 7

Basic AD&D Insurance Benefit Highlights .......................................................................... 7

Supplemental AD&D Insurance Benefit Highlights ......................................................... 10

Life Insurance Benefits For Your Child and Spouse Highlights ..................................... 11

AD&D Insurance Benefits For Your Spouse and Child Highlights ............................... 12

Reduction in Insurance at Age 70 ........................................................................................ 12

Chapter 3: Eligibility and Participation Information ............................................................................. 13

Eligibility for Participation .................................................................................................... 13

Date Insurance Takes Effect ................................................................................................. 14

Enrollment During Any Subsequent Annual Enrollment Period ................................... 16

Date Your Insurance Ends .................................................................................................... 18

Date Your Insurance For Your Spouse and Child Ends .................................................. 18

For Mentally or Physically Handicapped Children ............................................................ 19

When You Become Disabled ................................................................................................ 19

For Family and Medical Leave .............................................................................................. 21

Employees Who Cease Active Work ................................................................................... 21

Chapter 4: Evidence of Insurability ......................................................................................................... 21

Chapter 5: Life Insurance Benefits .......................................................................................................... 21

Basic and Supplemental Life Insurance Benefit Calculations .......................................... 21

Benefit Payment ...................................................................................................................... 22

Additional Features provided by Supplemental Life Insurance Coverage ..................... 22

Benefit Reductions ................................................................................................................. 23

Exclusions ................................................................................................................................ 23

Chapter 6: AD&D Insurance Benefits .................................................................................................... 23

Presumption of Death............................................................................................................ 23

Benefit Payment ...................................................................................................................... 23

Additional Features provided by AD&D Insurance ......................................................... 24

Benefit Reductions ................................................................................................................. 28

Exclusions ................................................................................................................................ 28

Exclusions for Intoxication ................................................................................................... 29

Chapter 7: Applying for Accelerated Benefit Option (ABO) .............................................................. 29

Claims for Accelerated Benefit Options (ABO) ................................................................ 29

Effect of Payment of an Accelerated Benefit ..................................................................... 31

Date Your, Your Spouse’s, or Your Child’s Option to Accelerate Benefits Ends ....... 31

Chapter 8: Claims and Appeals Procedures............................................................................................ 31

Claims for Life Insurance Benefits ....................................................................................... 32

Appealing Your Claim With MetLife ................................................................................... 32

MetLife Reviews Your Claim for Benefits .......................................................................... 32

Your Appeal is Reviewed....................................................................................................... 33

Appealing Your Claim for Eligibility ................................................................................... 33

You Can Appeal the Decision Regarding Eligibility ......................................................... 34


How To Use the Voluntary Final Appeal Process ............................................................. 35

Chapter 9: Continuing Life Insurance Coverage ................................................................................... 36

Conversion of Life Insurance ............................................................................................... 36

When You, Your Spouse, and Your Child Will Have the Option to Convert .............. 36

Portability For Life and AD&D Insurance ......................................................................... 37

Request Period ........................................................................................................................ 39

Chapter 10: General Information............................................................................................................... 39

Beneficiary ................................................................................................................................ 39

Entire Contract........................................................................................................................ 40

Incontestability: Statements made by You .......................................................................... 40

Misstatement of Age............................................................................................................... 40

Physical Exams ........................................................................................................................ 40

Autopsy .................................................................................................................................... 41

State Life Insurance Notices ................................................................................................. 41

Chapter 11: Plan Information ..................................................................................................................... 41

Chapter 12: Administrative Information................................................................................................... 42

Not a Contract of Employment ........................................................................................... 42

Non-Assignment of Benefits ................................................................................................ 42

Right of Recovery of Overpayment ..................................................................................... 43

Amendment or Termination ................................................................................................. 43

Severability ............................................................................................................................... 43

Additional Procedures ............................................................................................................ 43

Chapter 13: Federal Laws Impacting This Plan ....................................................................................... 43

Statement of ERISA Rights .................................................................................................. 43

Chapter 14: Definitions ............................................................................................................................... 45

6

Chapter 1: Contacts

Information about:

Claims for Benefits

MetLife Group Life Claims P.O. Box 6100 Scranton, PA 18505 1-800-638-6420

Information about:

Eligibility

Enrollment

When Coverage Begins or Ends

Cost of Coverage

General Questions

Changing Your Beneficiary

Benefits Administrator OZARK BORDER ELECTRIC COOPERATIVE P.O. BOX 400 POPLAR BLUFF, MO 63902-0400

Chapter 2: Benefit Highlights Under the Plan

This chapter includes the highlights of your Life Insurance and your Accidental Death and Dismemberment (AD&D) Insurance benefits under the Plan. For further information about these benefits, other benefits, and Plan exclusions – please read Chapters 5 and 6. Keep in mind: The Plans maximum benefit is 8 times salary (combination of Basic Life Insurance and Supplemental Life Insurance). The Plan’s maximum benefit is 8 times salary (combination of A&D Insurance and Supplemental AD&D Insurance).

You and your Spouse (see “Definitions”) and Child (see “Definitions”) will only be insured for the benefits:

for which you and your Spouse and Child become and remain eligible;

which you elect, if subject to election; and

which are in effect.

Basic Life Insurance Benefit Highlights

BENEFIT LEVEL COVERAGE WHO PAYS

4 x Salary Life Insurance benefit equal to four times your Base Annual Earnings

Employer

7

Maximum Basic Life Insurance Benefit

$1,000,000

Accelerated Benefit Option

Up to 80% of your Basic Life Insurance amount not to exceed $500,000

Supplemental Life Insurance Benefit Highlights


1x salary Life insurance benefit equal to your Base Annual Earnings

Employee

2x salary Life Insurance benefit equal to twice your Base Annual Earnings.

Employee

3x salary Life Insurance benefit equal to three times your Base Annual Earnings.

Employee

4x salary Life Insurance benefit equal to four times your Base Annual Earnings.

Employee

5x salary Life Insurance benefit equal to five times your Base Annual Earnings.

Employee

Maximum Supplemental Life Insurance Benefit

$1,500,000

Non-Medical Issue Amount

Up to 2 times your Base Annual Earnings


Up to 80% of your Supplemental Life Insurance amount not to exceed $500,000

Basic AD&D Insurance Benefit Highlights

Full Amount for Basic AD&D Insurance Benefit

Is equal to your Basic Life Insurance benefit amount

8

Maximum AD&D Insurance Benefit

$1,000,000

Common Disaster Benefit

NONE

Hospital Confinement YES

Schedule of Covered Losses for Basic AD&D Insurance Coverage:

All amounts listed are stated as percentages of the full amount of Basic AD&D Insurance coverage.

Loss of life 100%

Loss of a hand permanently severed at or above the wrist but below the elbow

50%

Loss of a foot permanently severed at or above the ankle but below the knee

50%

Loss of an arm permanently severed at or above the elbow

75%

Loss of a leg permanently severed at or above the knee

75%

Loss of sight in one eye

This means permanent and uncorrectable loss of sight in the eye. Visual acuity must be 20/200 or worse in the eye or the field of vision must be less than 20 degrees.

50%

Loss of any combination of hand, foot, or sight of one eye, as defined above

100%

Loss of the thumb and index finger of the same hand

This means that the thumb and index finger are permanently severed through or above the third joint from the tip of the index finger and the second joint from the tip of the thumb.

25%

Loss of speech and loss of hearing

This means the entire and irrecoverable loss of speech that continues for 6 consecutive months following the accidental injury and means the entire and irrecoverable loss of hearing in both

100%

9

ears that continues for 6 consecutive months following the accidental injury.

Loss of speech or loss of hearing

This means the entire and irrecoverable loss of speech that continues for 6 consecutive months following the accidental injury and means the entire or irrecoverable loss of hearing in both ears that continues for 6 consecutive months following the accidental injury.

50%

Paralysis* of both arms and both legs 100%

Paralysis* of both arms or both legs 50%

Paralysis* of the arm and leg on either side of the body

50%

Paralysis* of one arm or leg 25%

Brain Damage

This means permanent and irreversible physical damage to the brain causing the complete inability to perform all the substantial and material functions and activities normal to everyday life. Such damage must manifest itself within 30 days of the accidental injury, require a hospitalization of at least 5 days and persists for 12 consecutive months after the date of the accidental injury.

100%

Coma

This means a state of deep and total unconsciousness from which the comatose person cannot be aroused. Such state must begin within 30 days of the accidental injury and continue for 7 consecutive days.

1% monthly beginning on the 7th day of the Coma for the duration of the Coma to a maximum of 60 months

* Paralysis means the loss of use of a limb, without severance. A Physician (see “Definitions”) must determine the paralysis to be permanent, complete and irreversible.

Additional Features provided by Basic AD&D Insurance Coverage Highlights:

BENEFIT* AMOUNT BENEFITS

MINIMUM

BENEFIT MAXIMUM

Seat Belt Use 10% of Full Amount $1,000 $25,000.

10

Benefit

Air Bag Use Benefit

5% of Full Amount $1,000 $10,000

Child Care Benefit

Annual charges up to $5,000 per year for children under age 12.

$1,000 12% of Full Amount (overall

maximum).

Child Education Benefit

Annual charges up to $10,000 per year for up to 4 years.

$1,000 20% of the Full Amount

(overall maximum)

Spouse Education Benefit

Annual charge up to $5,000 for one academic year.

$1,000 3% of the Full Amount

(overall maximum)

Common Carrier Benefit

100% of the Full Amount N/A N/A

Rehabilitative Physical Therapy Benefit

Actual charges for up to 10 sessions up to 10% of the Full Amount

N/A $25,000.

* For specific requirements for these additional features please see Chapter 6.

Supplemental AD&D Insurance Benefit Highlights


1x salary AD&D benefit equal to your Base Annual Earnings

Employee

2x salary AD&D benefit equal to two times your Base Annual Earnings

Employee

3x salary AD&D benefit equal to three times your Base Annual Earnings

Employee

4x salary AD&D benefit equal to four times your Base Annual Earnings

Employee

5x salary AD&D benefit equal to five times your Base Annual Earnings.

Employee

Maximum Supplemental AD&D

$1,500,000

11

Insurance Benefit

Common Disaster Benefit

Yes (your Spouse must be a covered dependent in order to be eligible for this benefit)

For the Additional Features provided by Supplemental AD&D Insurance Coverage, please see “Additional Features provided by Basic AD&D Insurance Coverage Highlights” above.

For the Schedule of Covered Losses, please see “Basic AD&D Insurance Coverage Highlights” above.

Life Insurance Benefits For Your Child and Spouse Highlights


$10,000 Flat amount Life Insurance benefit for your Child. Same premium whether you have 1 Child or more than 1 Child.

Employee

$10,000 Flat amount Life Insurance benefit for your Spouse. Your Basic Life Insurance benefit must equal at least $10,000.

Employee


Employee


Employee


Employee


Employee

COVERAGE BENEFIT LEVEL

12


Up to 80% of your Spouse Life Insurance amount not to exceed $80,000

Non-Medical Issue Limit for Spouse Life Insurance

Up to $25,000

For each of your Children

$10,000


Up to 80% of your Child Life Insurance amount not to exceed $8,000

AD&D Insurance Benefits For Your Spouse and Child Highlights

Full Amount for Family AD&D Insurance coverage is based on family unit at time of loss.


Spouse and Child(ren) An amount equal to: (a) 40% for your Spouse, and (b) 10% for each Child, of your Supplemental AD&D Insurance coverage

Employee

Spouse Only An amount equal to 50% of your Supplemental AD&D Insurance coverage

Child Only An amount equal to 15% of your Supplemental AD&D Insurance coverage

For schedule of covered losses see Basic AD&D Insurance Coverage Highlights above.

Reduction in Insurance at Age 70

If you are age 70 or older on your effective date of participation, your Life and AD&D Insurance for you and your Spouse will be limited to the percentage shown below and reduced thereafter to the percentage shown below based on your age. If you are under age 70 on your effective date of participation, your Life and AD&D Insurance for you and your Spouse will be reduced to the percentage shown below on the first day of the month following the date you attain age 70 and thereafter as follows.

Your Age Percentage

70 through 74 60% of your benefit before age 70.

75 through 79 40% of your benefit before age 70.

13

Age 80 and over 26% of your benefit before age 70.

Your benefits and your Spouse’s benefits are reduced on the first of the month following your birthday. If your birthday is on the first of the month, your benefits and your Spouse’s benefits are reduced, the first day of the month following your birth month.

Your Base Annual Earnings (see “Definitions”) when you reach age 70 is the salary amount used to calculate your benefits after age 70. Any pay increases you receive after age 70 will not be included when calculating your benefits.

Example: Bridget has Base Annual Earnings of $25,000 when she reaches age 70, and her Life Insurance benefit is reduced. The next year her pay increases to $27,000. Her benefit will continue to be based on the $25,000 salary she had when she turned age 70.

Chapter 3: Eligibility and Participation Information

Eligibility for Participation

Eligible Class(es)

All Full-Time (see “Definitions”) Actively at Work (see “Definitions”) employees of the Employer (see “Definitions”) are eligible for the Plan if elected by your Employer. If you are enrolled under this Plan for insurance as a director, you will not be eligible under this Plan for insurance as an employee (see below “If You Become a Director”).

Further, to be considered eligible for participation you must be:

In a covered job classification, and

Have worked, or be expected to work, at least 1,000 hours during your first 12 months in a covered job classification, and

Continue to work at least 1,000 hours during subsequent calendar years, and

Have completed the eligibility waiting period (see “Eligibility Waiting Period” below), if any, for your Employer, or have worked at another rural electric employer within the past 6 months and met these conditions.

Ineligible Class(es)

The following classifications of employees are not eligible for coverage:

This Plan does not have any excluded job classifications, positions or titles.

Date You Are Eligible For Insurance

You are eligible only for the insurance available for your eligible class as shown in Chapter 2.

You will be eligible for insurance described in this SPD on the later of:

your Employer’s Effective Date; or

the day after the date you complete the Eligibility Waiting Period (see below “Eligibility

Waiting Period”) applicable to you.

Eligibility Waiting Period

14

Eligibility Waiting Period means the period of continuous membership in an eligible class that must be completed before you become eligible for insurance. This period begins on the date you enter an eligible class and ends on the date you complete the period(s) specified.

The Waiting Period for this Plan is: No Waiting Period is required by this Plan.

If You Become a Director

If you become a director, you may choose to enroll in a Director’s Life and AD&D Insurance Plan and/or Director’s AD&D Only Insurance Plan if your Employer participates in such plans and you are eligible to participate in them.

If you enroll in the Director’s Life and AD&D Insurance Plan, coverage under this Plan will end (see “Continuing Your Coverage”). If you choose the Director’s AD&D Only Insurance Plan, you may continue Basic Life Insurance coverage under this Plan as an employee.

For more information, please see your benefits administrator.

Husband and Wife Work for Cooperatives

If you and your spouse both work for cooperatives that participate in the NRECA Group Term Life and AD&D Insurance Plan, then the following Group Term Life and AD&D Insurance Plan coverage is allowable, provided each employee is eligible for coverage separately:

Husband and wife may be enrolled separately in Basic Life Insurance coverage as individual employees.

Husband and wife may be enrolled separately in Supplemental Life and Supplemental AD&D Insurance coverage as individual employees.

Husband and wife may each elect the Family AD&D Insurance coverage option for their Spouse and Child.

Husband and wife may each elect the Spouse Life Insurance coverage option for their Spouse.

Husband or wife (but not both) may elect Child Life Insurance coverage for their Child.

Date Insurance Takes Effect

Rules for Noncontributory Insurance

When you complete the enrollment process for Noncontributory Insurance (see “Definitions”), such insurance will take effect on the date you become eligible, provided you are Actively at Work on that date.

If you are not Actively at Work on the date the Noncontributory Insurance would otherwise take effect, the benefit will take effect on the day you resume Active Work.

Rules for Contributory Insurance

If you request Contributory Insurance (see “Definitions”) before the date you become eligible for the Life Insurance coverage you are requesting, such insurance will take effect as follows:

If you are not required to give evidence of your insurability (see “Chapter 4”), such

insurance will take effect on the date you become eligible, provided you are Actively at Work

on that date. You are not required to give evidence of your insurability for Basic Life

Insurance and AD&D Insurance.

15

If you are required to give evidence of your insurability and MetLife determines that you are

insurable, such insurance will take effect on the date MetLife states in Writing, provided you

are Actively at Work on that date. AD&D Insurance does not require evidence of your

insurability, but such insurance will not take effect until the day your Basic Life Insurance

takes effect.

If you request Contributory Insurance within 31 days after the date you become eligible for such insurance, such insurance will take effect as follows:

Upon enrollment, you are eligible for up to 2x salary of Supplemental Life Insurance coverage without completing a Statement of Health (see “Definitions”).

If you are not required to give evidence of your insurability, such insurance benefit will take

effect on the later of:

o the date you become eligible for such insurance; or

o the date you enroll provided you are Actively at Work on that date.

You are not required to give evidence of your insurability for Basic Life Insurance and

AD&D Insurance.

If you are required to give evidence of your insurability and MetLife determines that you are

insurable, such insurance will take effect on the date MetLife states in Writing, provided you

are Actively at Work on that date. AD&D Insurance does not require evidence of your

insurability, but such insurance will not take effect until the day your Basic Life Insurance

takes effect.

If you request Contributory Insurance (other than Supplemental AD&D Insurance) more than 31 days after the date you become eligible for such insurance, you must give evidence of your insurability satisfactory to MetLife. If MetLife determines that you are insurable, such insurance will take effect on the date MetLife states in Writing, if you are Actively at Work on that date.

If you complete the enrollment process for contributory Supplemental AD&D Insurance more than 31 days after the date you become eligible for such insurance, such insurance will not take effect until the day your Basic Life Insurance takes effect. Supplemental AD&D Insurance does not require evidence of your insurability.

For more information on evidence of insurability, please see “Chapter 4”.

Spouse and Child Life Insurance Enrollment Process

If you are eligible for Spouse and Child Life Insurance coverage, you may each apply for such insurance by completing an enrollment form for your Spouse and each Child to be insured. Upon your initial enrollment, your Spouse is eligible for up to $25,000 in life coverage and your child(ren) are eligible for up to $10,000 of coverage without providing evidence of insurability. In addition, if you enroll your spouse and child more than 31 days after you are first eligible, your Spouse and each of your Children must give evidence of insurability satisfactory to MetLife if required to do so – please see Chapter 4. If you apply for Contributory Insurance, you must also give your Employer written permission to deduct premiums from your pay for such insurance. You will be notified by your Employer regarding how much you will be required to contribute.

16

On the date the Spouse or Child Life Insurance is scheduled to take effect, the Spouse or Child must not be:

Confined at home or under a Physician’s care;

receiving or applying to receive Disability (“Definitions”) benefits from any source; or

Hospitalized (see “Definitions”).

Spouse or Child Life Insurance will take effect on the date he or she is no longer:

Confined at home or under a Physician’s care;

receiving or applying to receive Disability benefits from any source; or

Hospitalized.

Enrollment During Any Subsequent Annual Enrollment Period

During any annual enrollment period as determined by your Employer, you may enroll in insurance for which you, your Spouse or your Children are eligible or choose a different option than the one for which you, your Spouse or your Children are currently enrolled. The insurance enrolled in, or changes to your insurance made during an annual enrollment period, will take effect as follows:

For any coverage amount for which you are not required to give evidence of your

insurability, such insurance that will take effect on the first day of the month following the

annual enrollment period, if you are Actively at Work on that date. You are not required to

give evidence of your insurability for Supplemental AD&D Insurance.

For any coverage amount for which you are required to give evidence of your insurability

and MetLife determines that you are insurable, such insurance will take effect on the date

MetLife states in Writing, if you are Actively at Work on that date. Supplemental AD&D

Insurance does not require evidence of your Insurability but such insurance will not take

effect until the day your Basic Life Insurance takes effect.

If you are not Actively at Work on the date an amount of insurance would otherwise take effect, that amount of insurance will take effect on the day you resume Active Work. For a Contributory Life Insurance Benefit to take effect, in addition to being Actively at Work on the date the insurance benefit is to take effect, you must also have been Actively at Work for at least 20 hours during the 7 calendar days preceding that date.

Enrollment Due to a Qualifying Event

Under the rules of the Plan, you may apply for insurance for which you are eligible or change the amount of your insurance between annual enrollment periods only if you have a Qualifying Event. If you are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on the day you resume Active Work.

Qualifying Event includes:

marriage;

the birth, adoption or placement for adoption of a dependent child;

divorce or annulment;

17

court-appointed legal guardianship;

the death of a Spouse or Child; or

Child ceases to qualify as a Child under the terms of the Plan.

If you have a Qualifying Event, you will have 31 days from the date of that event to make a request for enrollment. The insurance enrolled for or changes to your insurance made as a result of a Qualifying Event will take effect as follows:

For any coverage amount for which you are not required to give evidence of your

insurability, such insurance will take effect on the first day of the month following the date

of your request, if you are Actively at Work on that date. You are not required to give

evidence of your insurability for Supplemental AD&D Insurance.

For any coverage amount for which you are required to give evidence of your insurability

and MetLife determines that you are insurable, such insurance will take effect on the date

MetLife states in Writing, if you are Actively at Work on that date. Supplemental AD&D

Insurances does not require evidence of your insurability but such insurance will not take

effect until the day your Basic Life Insurance takes effect.

Increase in Insurance Due to a Qualifying Event

A requested increase of coverage due to a Qualifying Event will require completion of a Statement of Health (SOH) application for requested coverage amounts over the Non-Medical Issue Amount (see “Definitions”), and will take effect as follows:

If you are not required to give SOH, the increase will take effect on the date of your

request.

If you are required to give a Statement of Health (subject to approval from MetLife), the

increase will take effect the day Written (see “Definitions”) approval is received.

If you are not Actively at Work on the date insurance would otherwise take effect, the insurance change will take effect on the day you resume Active Work. For a Contributory Life Insurance Benefit to take effect, in addition to being Actively at Work on the date the insurance benefit is to take effect, you must also have been Actively at Work for at least 20 hours during the 7 calendar days preceding that date.

Increase in Life Insurance for Your Spouse Due to a Qualifying Event

A requested increase in insurance for your Spouse due to a Qualifying Event, will take effect as follows:

If your Spouse is required to give evidence of insurability, the increase will take effect on

the date MetLife states in Writing. If MetLife does not approve the SOH, or you do not

submit one for your Spouse, the increase in insurance for your Spouse will not take effect.

If your Spouse is required to give evidence of insurability for a portion of the increase in

insurance:

o The portion of the increase in insurance that is not subject to evidence of insurability

will take effect on the date of your request.

18

o If MetLife approves the SOH, the portion of the increase in benefit that is subject to

evidence of insurability will take effect on the date MetLife states in Writing. If

MetLife does not approve the SOH or you do not submit one for your Spouse, the

increase in insurance for your Spouse will not take effect.

If your Spouse is not required to give evidence of insurability, the increase will take effect

on the date of your request.

You must be Actively at Work on that date. If you are not Actively at Work on the date the increase would otherwise take effect, the increase will take effect on the day you resume Active Work.

Decrease in Insurance Due to a Qualifying Event

If you make a Written application to decrease your or your Spouse’s insurance, that decrease will take effect as of the date of your application.

Date Your Insurance Ends

Your insurance will end on the earliest of:

the date the Plan ends; or

the date insurance eligibility ends for your employee classification; or

the end of the period for which the last premium has been paid for you; or

the date your employment ends. Your employment will end if you cease to be Actively at

Work in any eligible employee classification for your Employer, except as provided in

Chapter 3 “When You Become Disabled”; or

the date you retire in accordance with the Employer’s retirement plan.

You can convert or Port all or part of your former coverage (see “Chapter 9”). In certain cases your Life Insurance may be continued, such as if you are Disabled (see “Definitions”). Please refer to Chapter 3 “When You Become Disabled” for information regarding the option to continue your coverage while Disabled and still employed by your Employer.

Date Your Insurance For Your Spouse and Child Ends

A Spouse’s or Child’s insurance will end on the earliest of:

for Spouse or Child Life Insurance, the date all of the Life Insurance under the Plan ends; or

for Family AD&D Insurance, the date your Supplemental AD&D Insurance under the Plan

ends; or

the date you die; or


the date insurance for your Spouse and Child ends under the Plan; or

the date insurance for your Spouse and Child ends for your class of employees; or

the date the person ceases to be a Spouse or Child; or

the date your employment ends (your employment will end if you cease to be Actively at

Work in any eligible employee classification for your Employer, except as provided in

Chapter 3 “When You Become Disabled”); or

19

the date you retire in accordance with the Employer’s retirement plan; or

the end of the period for which the last premium has been paid for the Spouse or Child Life

Insurance or Family AD&D Insurance.

Please refer to Chapter 9 for information concerning the option to continue coverage through an individual policy of life insurance if Life Insurance for a Spouse or Child ends.

For Mentally or Physically Handicapped Children

Insurance for a Child may be continued past the age limit if the child is incapable of self-sustaining employment because of a mental or physical handicap as defined by applicable law. Proof (see “Definitions”) of such handicap must be sent to MetLife within 31 days after the date the Child attains the age limit and at reasonable intervals after such date.

Subject to the section above (see “Date Your Insurance For Your Spouse and Child Ends”), insurance will continue while such Child:

remains incapable of self-sustaining employment because of a mental or physical handicap;

and

continues to qualify as a Child, except for the age limit.

When You Become Disabled

If Your Disability Occurs Before Normal Retirement Age

If you become Disabled before your Employer’s Normal Retirement Age (see “Definitions”), you may qualify to continue your Basic Life Insurance, Basic AD&D Insurance and Supplemental Life Insurance coverage with premiums waived. NRECA will determine if you qualify for this continuation after Proof is received, that you have satisfied the conditions of this section. The conditions are:

You and/or your benefits administrator submit to NRECA the forms to qualify your Disability, and

You meet the definition of Disability or Disabled , and

You keep your status as an employee and have not terminated your employment or retired, and

You continue to pay your share of the premiums, if any, and

Your Employer continues to participate in the NRECA Group Term Life and AD&D Insurance Plan.

If you meet the above conditions, your premiums for Basic Life Insurance, Basic AD&D Insurance and Supplemental Life Insurance are waived after six months of Disability. This means you do not have to pay your share of the cost of your coverage after the waiver takes effect. This waiver takes effect on the first of the month on or after six months from the date of your Disability. Premiums, however, must be paid when due for coverage for the first six months of Disability.

The amount of insurance provided will be the same as the amount in force on the date last worked. For this purpose, your Base Annual Earnings and Life Insurance amount in force are frozen as of the date last worked and remain at those amounts until you return to work, retire or terminate your employment.

20

The premium waiver does not apply to Spouse Life Insurance, Child Life Insurance, Supplemental AD&D Insurance and Family AD&D Insurance. You would have to pay the full premiums to continue these coverages until they would otherwise end, or you retire.

As a Disabled employee, your Life Insurance will end

if you do not pay your premium between the date of your Disability and the date your premium waiver takes effect, or

when you are no longer employed by your Employer because you terminated your employment or retired, or

when you reach your Employer’s Normal Retirement Age, or

if your Employer stops participating in the Plan

As a Disabled employee, your waiver of premium will end

when you reach your Employer’s Normal Retirement Age, or

if you return to active employment, or

your insurance ends (as outlined above).

When your Life Insurance ends, you will no longer be able to participate in the Basic Life Insurance, Basic AD&D Insurance and Supplemental Life Insurance coverages, and the premium waiver ends.

You can convert or Port all or part of your former coverage (see “Chapter 9”).

If you retire while you are Disabled, or reach your Employer’s Normal Retirement Age while Disabled, you may

enroll in Retired Life Insurance if offered by your Employer, or

convert or Port to an individual policy (see “Chapter 9”) o the amount of coverage not covered by Retired Life Insurance, or o the full amount of your coverage as a Disabled Employee if you decide not to enroll in

Retired Life Insurance.

If Your Disability Occurs After Normal Retirement Age

If you are an Active Employee and become Disabled after the Normal Retirement Age for your Employer, your Basic Life Insurance, Basic AD&D Insurance and Supplemental Life Insurance coverage will continue for six months

subject to any benefit reductions if you are over age 70, and

so long as your Employer continues to participate in the NRECA Group Term Life and AD&D Insurance Plan.

After six months, the Basic Life Insurance, Basic AD&D Insurance and Supplemental Life Insurance coverage you had as an employee will end.

You may

enroll in Retired Life Insurance if offered by your Employer, or

convert or Port to an individual policy (see “Chapter 9”) o the amount of coverage not covered by Retired Life Insurance, or o the full amount of your coverage as an Active Employee if you decide not to enroll in

Retired Life Insurance.

21

For Family and Medical Leave

Certain leaves of absence may qualify under the Family and Medical Leave Act of 1993 (FMLA) for continuation of insurance. Please contact the Employer for information regarding the FMLA.

Employees Who Cease Active Work

The Employer may elect to continue insurance by paying premiums for its employees who cease Active Work. Please see your Employer for more information.

If your insurance ends, your Spouse’s and Child’s insurance will also end.

Chapter 4: Evidence of Insurability

MetLife may require satisfactory evidence of insurability before it will issue coverage. The evidence of insurability is to be given by filing out a Statement of Health (SOH) form. Evidence of insurability is needed in the following circumstances:

If you wish to increase the amount of your Supplemental or Spouse Life Insurance above a

Non-Medical Issue Amount during your initial eligibility or during a qualified life event:

o Evidence of your insurability will be required by MetLife within 31 days of the date of the elected coverage. If such evidence of insurability is not submitted to or accepted by MetLife as satisfactory within 60 days, the amount of Life Insurance coverage will be limited to the amount previously in force or the Non-Medical Issue Amount.

If you wish to increase the amount of any Life Insurance coverage during your employers annual enrollment period:

o Evidence of your insurability will be required by MetLife prior to the effective date of the elected coverage. If such evidence of insurability is not submitted to or accepted by MetLife as satisfactory within 60 days, the amount of Life Insurance coverage will be limited to the amount previously in force.

If you make a late request for Life Insurance - either 31 days after initial eligibility or 31 days

after a qualified event - you will then need to wait until your Employer’s next annual

enrollment period or the next Qualifying Event (see “Chapter 3”) .

If MetLife requests evidence of insurability due to the circumstances described above, either you or your Spouse must complete a SOH to determine if you, your Spouse, or your Children can be insured by the Plan.

Chapter 5: Life Insurance Benefits

Basic and Supplemental Life Insurance Benefit Calculations

For coverage purposes on salary multiple plans, your Base Annual Earnings are rounded up to the next $1,000 then multiplied by the selected salary multiplier chosen for the plan amount (1x, 2x, 3x salary, etc.)

22

Benefit Payment

Your Beneficiary will receive payment of Life Insurance benefits of five thousand dollars ($5,000) or more through an interest-bearing account with check-writing privileges known as a “Total Control Account (TCA)” that is guaranteed by MetLife. The TCA preserves your Beneficiary’s right to choose among other settlement options offered by MetLife at the time that the TCA is established.

Additional Features provided by Supplemental Life Insurance Coverage

MetLife Will Preparation Benefit

You will be eligible to use your MetLife Will Preparation Benefit, provided by Hyatt Legal Plans, once your Supplemental Life Insurance benefit becomes effective.

When you use the Hyatt Legal Plan’s network, the Will Preparation Benefit fully covers the following legal fees:

Telephone and office consultations to discuss the preparation or updating of your Will or your spouse’s Will;

Preparation of the Will(s);

Updating of the Will(s);

Preparation of Codicils; and

Documents such as Living Wills, Powers of Attorney.

There is no limit to the number of Wills or updates to your Will(s) or your spouse’s Will(s) that are covered under this benefit.

The following is not covered under this Will Preparation Benefit:

Tax Planning;

Non-attorney fees; and

A Living Trust, which is a Trust that takes effect during a person’s lifetime.

You may use an attorney outside of the Hyatt Legal Plans’ network and receive reimbursement of a pre-determined amount for attorneys’ fees for preparation of your Will(s). Further information is available through Hyatt Legal Plans.

Program details and contact information can be obtained from your Benefits Administrator or by visiting the document library: Cooperative.com > NRECA Employee Benefits > Document Library > Documents for Employees > Life Insurance Plans.

MetLife Estate Resolution Services

Your Beneficiary (see “Definitions”) will automatically be eligible to use the Estate Resolution Services, provided by Hyatt Legal Plans, once your Supplemental Life Insurance benefit becomes effective and after your death.

Estate Resolution Services are available to your Beneficiary and cover the following probate services when your Beneficiary contacts the Hyatt Legal Plan’s network:

Telephone and office consultations to discuss matters related to probating your estate;

Preparation of documents related to probating your estate;

Representation at court proceedings related to probating your estate;

Completion of correspondence necessary to transfer probate assets (insurance policies, joint; bank accounts, stock accounts and property); and

23

Associated tax filings related to probating your estate.

Your Beneficiary may use an attorney outside of the Hyatt Legal Plans’ network and receive reimbursement of a pre-determined amount for attorneys’ fees for Estate Resolution Services. Further information is available through Hyatt Legal Plans.

Program details and contact information can be obtained from your Benefits Administrator or by visiting the document library: Cooperative.com > NRECA Employee Benefits > Document Library > Documents for Employees > Life Insurance Plans.

Benefit Reductions

Please see Chapter 2, section “Reduction in Insurance When You Turn 70” for more information.

Exclusions

There are no exclusions under Life Insurance.

Chapter 6: AD&D Insurance Benefits

If you or a Spouse or Child sustain an accidental injury that is the Direct and Sole Cause of a Covered Loss described in Chapter 2, Proof of the accidental injury and Covered Loss must be sent to MetLife. When MetLife receives such Proof, it will review the claim and, if MetLife approves it, it will pay the insurance in effect on the date of the injury.

Direct and Sole Cause means that the Covered Loss occurs within 12 months of the date of the accidental injury and was a direct result of the accidental injury, independent of other causes.

MetLife will deem a loss to be the direct result of an accidental injury if it results from unavoidable exposure to the elements and such exposure was a direct result of an accident.

Presumption of Death

You and/or a Spouse or Child will be presumed to have died as a result of an accidental injury if:

The aircraft or other vehicle in which you and/or a Spouse or Child were travelling

disappears, sinks, or is wrecked; and

The body of the person who has disappeared is not found within 1 year of:

o The date the aircraft or other vehicle was scheduled to have arrived at its destination,

if travelling in an aircraft or other vehicle operated by a Common Carrier; or

o The date the person is reported missing to the authorities, if travelling in any other

aircraft or other vehicle.

Benefit Payment

For the loss of your life, MetLife will pay the AD&D Insurance benefits to your Beneficiary.

For any other loss sustained by you, or for any loss sustained by a Spouse or Child, MetLife will pay the AD&D Insurance benefits to you.

If you or a Spouse or Child sustain more than one Covered Loss due to an accidental injury, the amount MetLife will pay, on behalf of any such injured person, will not exceed the Full Amount of AD&D Insurance coverage (see “Chapter 2”).

24

MetLife will pay AD&D Insurance benefits in one sum. Other modes of payment may be available upon request. For details call MetLife’s toll free number 1-800-638-6420.

If Base Annual Pay over $250,000

Due to the compensation limit imposed by the Internal Revenue Code, effective January 1, 1994, no more than $250,000 of Base Annual Earnings (in 2012 and adjusted each year for inflation) may be considered when the Plan calculates your AD&D Insurance benefit.

However, a supplemental insurance policy outside the NRECA Group Benefits Trust has been established to provide benefits to the extent an employee’s salary exceeds the $250,000 (in 2012) compensation limit. This supplemental insurance policy is provided under the NRECA Excess AD&D Insurance Plan.

Your Beneficiary will receive one check for the full amount of your benefit.

Total Control Account

You or your Beneficiary will receive payment of AD&D Insurance benefits of five thousand dollars ($5,000) or more through an interest-bearing account with check-writing privileges known as a “Total Control Account (TCA)” that is guaranteed by MetLife. The TCA preserves your or your Beneficiary’s right to choose among other settlement options offered by MetLife at the time that the TCA is established.

Additional Features provided by AD&D Insurance

The features set forth in this section apply to all AD&D Insurance included in this SPD except as may otherwise be provided in the specific section (see “Chapter 2”).

Seat Belt Use Benefit

If you or a Spouse or Child die as a result of an accidental injury, MetLife will pay this additional Seat Belt (see “Definitions”) Use benefit if:

MetLife pays an AD&D Insurance benefit for loss of life;

This AD&D Insurance benefit is in effect on the date of the injury; and

MetLife receives Proof that the deceased person:

o Was in an accident while driving or riding as a passenger in a Passenger Car (see

“Definitions”);

o Was wearing a Seat Belt which was properly fastened at the time of the accident; and

o Died as a result of injuries sustained in the accident.

A police officer investigating the accident must certify that the Seat Belt was properly fastened. A copy of such certification must be submitted to MetLife with the claim for benefits.

Benefit Amount

The Seat Belt Use benefit is an additional benefit equal to 10% of your Full Amount of AD&D Insurance (see “Chapter 2”). However, the amount MetLife will pay for this benefit will not be less than $1,000 or more than $25,000.

Benefit Payment

For the loss of your life, MetLife will pay benefits to your Beneficiary. For the loss of a Spouse’s or Child’s life, MetLife will pay benefits to you.

25

Air Bag Use Benefit

If you or a Spouse or Child die as a result of an accidental injury, MetLife will pay this additional benefit if:

MetLife pays AD&D Insurance benefits for loss of life;

This benefit is in effect on the date of the injury; and

MetLife receives Proof that the deceased person:

o Was in an accident while driving or riding as a passenger in a Passenger Car equipped

with an Air Bag(s) (see “Definitions”);

o Was riding in a seat protected by an Air Bag;

o Was wearing a Seat Belt which was properly fastened at the time of the accident; and

o Died as a result of injuries sustained in the accident.

A police officer investigating the accident must certify that the Seat Belt was properly fastened and that the Passenger Car in which the deceased was travelling was equipped with Air Bags. A copy of such certification must be submitted to MetLife with the claim for benefits.

Benefit Amount

The Air Bag Use Benefit is an additional benefit equal to 5% of the Full Amount of AD&D Insurance benefits shown in Chapter 2. However, the amount MetLife will pay for this benefit will not be less than $1,000 or more than $10,000.

Benefit Payment

For the loss of your life, MetLife will pay benefits to your Beneficiary. For the loss of a Spouse’s or Child’s life, MetLife will pay benefits to you.

Child Care Benefit

If you died as a result of an accidental injury, MetLife will pay this additional Child Care benefit if:

MetLife pays AD&D Insurance for the loss of your life;


MetLife receives Proof that:

o On the date of your death, a Child was enrolled in a Child Care Center (see

“Definitions”); or

o Within 12 months after the date of your death, a Child was enrolled in a Child Care

Center.

Benefit Amount

For each Child who qualifies for this benefit, MetLife will pay an amount equal to the Child Care Center charges incurred for a period of up to 4 consecutive years, not to exceed:

An annual maximum of $5,000; and

An overall maximum of 12% of the Full Amount of AD&D Insurance benefits shown in

Chapter 2.

MetLife will not pay for Child Care Center charges incurred after the date a Child attains age 12.

26

MetLife may require Proof of the Child’s continued enrollment in a Child Care Center during the period for which a benefit is claimed.

Benefit Payment

MetLife will pay this benefit quarterly when MetLife receives Proof that Child Care Center charges have been paid. Payment will be made to the person who pays such charges on behalf of the Child.

If this benefit is in effect on the date you die and there is no Child who could qualify for it, MetLife will pay $1,000 to your Beneficiary in one sum.

Child Education Benefit

If you die as a result of an accidental injury, MetLife will pay this additional Child Education benefit if:

MetLife pays an AD&D Insurance benefit for the loss of your life;


MetLife receives Proof that on the date of your death a Child was:

o Enrolled as a full-time student in an accredited college, university or vocational school

above the 12th grade level; or

o At the 12th grade level and, within one year after the date of your death, enrolls as a full-

time student in an accredited college, university or vocational school.

Benefit Amount

For each Child who qualifies for this benefit, MetLife will pay an amount equal to the tuition charges incurred for a period of up to 4 consecutive academic years, not to exceed:

An academic year maximum of $10,000; and

An overall maximum of 20% of the Full Amount shown in Chapter 2

MetLife may require Proof of the Child’s continued enrollment as a full-time student during the period for which a benefit is claimed.

Benefit Payment

MetLife will pay this benefit semi-annually when MetLife receives Proof that tuition charges have been paid. Payment will be made to the person who pays such charges on behalf of the Child.

If this benefit is in effect on the date you die and there is no Child who would qualify for it, MetLife will pay $1,000 to your Beneficiary in one sum.

Spouse Education Benefit

If you die as a result of an accidental injury, MetLife will pay this additional Spouse Education benefit if:

MetLife pays an AD&D Insurance benefit for the loss of your life;


MetLife receives Proof that:

o On the date of your death, your Spouse was enrolled as a full-time student in an

accredited school; or

27

o Within 12 months after the date of your death, your Spouse enrolls as a full-time student

in an accredited school.

Benefit Amount

MetLife will pay an amount equal to the tuition charges incurred for a period of up to 1 academic year, not to exceed:

An academic year maximum of $5,000; and

An overall maximum of 3% of the Full Amount shown in Chapter 2.

MetLife may require Proof of the Spouse’s continued enrollment as a full-time student during the period for which a benefit is claimed.

Benefit Payment

MetLife will pay this benefit semi-annually when MetLife receives Proof that tuition charges have been paid. Payment will be made to the Spouse.

If this benefit is in effect on the date you die and there is no Spouse who could qualify for it, MetLife will pay $1,000 to your Beneficiary in one sum.

Hospital Confinement Benefit

Subject to the provisions of your AD&D Insurance, MetLife will pay this additional benefit if:

MetLife receives Proof that you are confined in a Hospital (see “Definitions”) as a result of

an accidental injury which is the direct result of such confinement independent of other

causes; and

This benefit is in effect on the date of the injury.

Benefit Amount

MetLife will pay an amount for each full month of Hospital Confinement equal to the lesser of:

1% of the Full Amount shown in Chapter 2; or

$2,500.

MetLife will pay this benefit on a monthly basis beginning on the 5th day of confinement, for up to 12 months of continuous confinement. This benefit will be paid on a pro-rata basis for any partial month of confinement.

MetLife will only pay benefits for one period of continuous confinement for any accidental injury. That period will be the first period of confinement that qualifies for payment.

Benefit Payment

Benefit payments will be made monthly to you.

Common Carrier Benefit

If you or a Spouse or Child dies as a result of an accidental injury, MetLife will pay this additional benefit if:

MetLife pays an AD&D Insurance benefit for loss of life;

28


MetLife receives Proof that the injury resulting in the deceased’s death occurred while

travelling in a Common Carrier.

Benefit Amount

The Common Carrier Benefit is an amount equal to the Full Amount of AD&D Insurance benefits shown in Chapter 2.

Benefit Payment

For the loss of your life, MetLife will pay benefits to your Beneficiary. For the loss of your Spouse’s or Child’s life, MetLife will pay benefits to you.

Rehabilitative Physical Therapy Benefit

Subject to the terms of your AD&D Insurance, MetLife will pay this additional benefit if:

MetLife receives Proof that rehabilitative physical therapy has been prescribed within 90

days of the accidental injury by the attending Physician as necessary to treat a physical

condition resulting from the accidental injury; and

This benefit is in effect on the date of the injury.

Such rehabilitative physical therapy must be provided within 1 year of the accidental injury by a Physician or therapist licensed to provide the therapy in the jurisdiction where such services are performed.

Benefit Amount

MetLife will pay an amount equal to the least of:

The actual charges incurred for 10 sessions of Rehabilitative Physical Therapy; or

10% of the Full Amount of AD&D Insurance coverage shown in Chapter 2; or

$25,000.

Benefit Payment

MetLife will pay this benefit quarterly when MetLife receives Proof that charges for Rehabilitative Physical Therapy have been paid. Payment will be made to you.

Common Disaster

If you and your Spouse are injured in the same accident and die within 365 days as a result of injuries in such accident, the Full Amount of AD&D Insurance benefits that MetLife will pay for your Spouse’s loss of life will be increased to equal the Full Amount of AD&D Insurance benefits payable for the loss of your life.

Benefit Reductions

Please see Chapter 2, section “Reduction in Insurance When You Turn 70” for more information.

Exclusions

MetLife will not pay AD&D Insurance benefits under this Chapter for any loss caused or contributed by:

29

Physical or mental illness or infirmity, or the diagnosis or treatment of such illness or

infirmity;

Infection, other than infection occurring in an external accidental wound;

Suicide or attempted suicide;

Intentionally self inflicted injury;

Service in the armed forces of any country or international authority, except the United

States National Guard;

Any incident related to:

o Travel in an aircraft as a pilot, crew member, flight student;

o Travel in an aircraft for the purpose of parachuting or otherwise exiting from such

aircraft while it is in flight;

o Parachuting or otherwise exiting from an aircraft while such aircraft is in flight, except

for self preservation;

o Travel in an aircraft or device used:

For testing or experimental purposes;

By or for any military authority; or

For travel or designed for travel beyond the earth’s atmosphere;

Committing or attempting to commit a felony;

The voluntary intake or use by any means of:

o Any drug, medication or sedative, unless it is:

Taken or used as prescribed by a Physician, or

An “over the counter” drug, medication or sedative taken as directed;

o Alcohol in combination with any drug, medication, or sedative; or

o Poison, gas, or fumes; or

War, whether declared or undeclared, or act of war, insurrection, rebellion or riot.

Exclusions for Intoxication

MetLife will not pay AD&D Insurance benefits under this Chapter for any loss if the injured party is intoxicated at the time of the incident and is the operator of a vehicle or other device involved in the accident.

Intoxicated means that the injured person’s blood alcohol level met or exceeded the level that creates a legal presumption of intoxication under the laws of the jurisdiction in which the incident occurred.

Chapter 7: Applying for Accelerated Benefit Option (ABO)

Claims for Accelerated Benefit Options (ABO)

For purposes of this section, the term “ABO Eligible Life Insurance” refers to each of your Life Insurance coverages for which the Accelerated Benefit Option (ABO) is shown as available in Chapter 2. This section includes you, your Spouse’s, or your Child’s ABO. This section does not apply to your AD&D Insurance coverage.

30

If you become Terminally Ill, you or your legal representative have the option to request MetLife to pay ABO Eligible Life Insurance before your death. This is called an accelerated benefit. The request must be made while ABO Eligible Life Insurance is in effect.

Terminally Ill or Terminal Illness means that due to injury or sickness, you are expected to die within 12 months.

For residents of Texas only:


Requirements For Payment of an Accelerated Benefit

Subject to the conditions and requirements of this section, MetLife will pay an accelerated benefit to you or your legal representative if:

The amount of each ABO Eligible Life Insurance benefit to be accelerated equals or exceed

$10,000; and

MetLife have received Proof that you are Terminally Ill.

MetLife will only pay an accelerated benefit for each ABO Eligible Life Insurance benefit once.

Proof of Your, Your Spouse’s, or Your Child’s Terminal Illness

MetLife will require the following Proof of your Terminal Illness:

A completed accelerated benefit claim form;

A Signed (see “Definitions”) Physician’s certification that you are Terminally Ill; and

An examination by a Physician of MetLife’s choice, at MetLife’s expense, if MetLife requests

it.

You or your legal representative should contact the Employer to obtain a claim form and information regarding the accelerated benefit.

Upon MetLife’s receipt of your request to accelerate benefits, MetLife will send you a letter with information about the accelerated benefit payment you requested. MetLife’s letter will describe the amount of the accelerated benefits MetLife will pay and the amount of Life Insurance remaining after the accelerated benefit is paid. The remaining benefit will be paid to your Beneficiary upon your death.

Accelerated Benefit Amount

MetLife will pay an accelerated benefit up to the percentage shown in Chapter 2 for each ABO Eligible Life Insurance benefit in effect for you, subject to the following:

Maximum Accelerated Benefit Amount. The maximum amount MetLife will pay for each ABO Eligible Life Insurance benefit is show in Chapter 2.

Scheduled Reduction of an ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance benefit is scheduled to reduce, due to age or attainment of Normal Retirement Age, within the 12 month period after the date you or your legal representative request an accelerated benefit, MetLife will calculate the accelerated

31

benefit using the amount of such ABO Eligible Life Insurance that will be in effect immediately after the reduction(s) scheduled for such period.

Scheduled End of an ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance benefit is scheduled to end (for example – due to attainment of Normal Retirement Age) within 12 months after the date you or your legal representative request an accelerated benefit, MetLife will not pay an accelerated benefit for such ABO Eligible Life Insurance benefit.

Previous Conversion of an ABO Eligible Life Insurance Benefit. MetLife will not pay an accelerated benefit for any amount of ABO Eligible Life Insurance which you previously converted under Chapter 9.

MetLife will pay the accelerated benefit in one sum unless you or your legal representative select another payment mode.

Effect of Payment of an Accelerated Benefit

On Premium for Your Life Insurance

After MetLife pays the accelerated benefit, any premium you are required to pay will be based upon the amount of your Life Insurance remaining after the accelerated benefit is paid.

On Your Life Insurance at Your Death

The amount of Life Insurance that MetLife will pay at your death will be decreased by the amount of the accelerated benefit paid by MetLife.

On Your Life Insurance at Conversion/Portability

The amount of Life Insurance which you are entitled to continue under Chapter 9 will be decreased by the amount of the accelerated benefit paid by MetLife.

On Your AD&D Insurance Coverage

Payment of an accelerated benefit will not affect your AD&D Insurance coverage.

Date Your, Your Spouse’s, or Your Child’s Option to Accelerate Benefits Ends

The accelerated benefit option will end on the earliest of:

The date the ABO Eligible Life Insurance ends;

The date you or your legal representative have accelerated all ABO Eligible Life Insurance

benefits;

The date you retire;

The date you terminate employment; or

Upon your death.

Chapter 8: Claims and Appeals Procedures

Your Benefit Administrator at your Employer will report all deaths and receive a claim packet. Obtain the claim packet from your Benefits Administrator and fill it out carefully. Return the completed claim form with the required Proof to the Employer. The Employer will certify your insurance under the Plan and send the certified claim form and Proof to MetLife.

32

When MetLife receives the claim form and Proof, MetLife will pay benefits subject to the terms and provisions of this SPD and the Plan.

Claims for Life Insurance Benefits

When a claimant files a claim for Life Insurance benefits, Proof should be sent to MetLife as soon as is reasonably possible after the death of an insured.

Time Limit on Legal Actions

A legal action on a claim may only be brought against MetLife during a certain period. This period begins 60 days after the date Proof is filed and ends 3 years after the date such Proof is required.

Proof

If you, your Spouse, or your Child die, Proof of death must be sent to MetLife. When MetLife receives such Proof with the claim, MetLife will review the claim and, if MetLife approves it, MetLife will pay the Beneficiary the Life Insurance in effect on the date of your death.

Payment Options

MetLife will pay the Life Insurance in one sum. Other modes of payment may be available upon request. For details, call MetLife’s toll free number 1-800-638-6420.

Appealing Your Claim With MetLife

If MetLife denies a claim for benefits for you, your spouse or your child, this decision may be appealed, following MetLife’s appeals process. Appeals may be filed by:

You,

Your Beneficiary, or the Beneficiary for your spouse or your child, or

Your authorized representative.

An authorized representative is a person you authorize in writing to act on your behalf. An authorized representative may not be a doctor or other health care provider.

Please note: There are specific response time periods for your claims and appeals. Below is the process for reviewing claims and filing claims or appeals. If you need more information, please contact your benefits administrator.

MetLife Reviews Your Claim for Benefits

After MetLife receives your claim for benefits under this Plan, MetLife will review your claim and notify you within 90 days of the date it receives your claim whether your claim is approved or denied.

In some cases, MetLife may need a 90-day extension. You will be notified that it needs more time to evaluate your claim before the initial 90-day period is over.

If MetLife denies your claim in whole or in part, the denial notice will:

state the reason why your claim was denied;

refer to the specific Plan provision(s) on which the denial is based;

describe any additional information needed and why this information is needed;

explain the Plan review procedures and time limits; and

include a statement of your right to bring a civil action if your claim is denied after an appeal.

33

Upon your written request, MetLife will provide you, free of charge, with copies of relevant documents, records and other information.

You May Appeal the Initial Determination

You, your Beneficiary or your authorized representative may request a review of your claim by MetLife within 60 days after the date you receive the denial notice.

When requesting a review:

submit your request in writing;

state the reason you, your Beneficiary or authorized representative believe the claim was improperly denied;

include any written comments, documents, records or other information to support your appeal, even if you have already submitted these materials; and

send it to “Group Insurance Claims Review” at the address of the MetLife office which processed the claim.

Your Appeal is Reviewed

MetLife has 60 days from the date it receives your request for review to

re-evaluate all of the information;

conduct a full and fair review of the claim; and

notify you, your Beneficiary or authorized representative of its decision.

In some cases, MetLife may need a 60-day extension. You, your Beneficiary or authorized representative will be notified if more time is needed to evaluate your appeal before the initial 60-day period is over.

If your appeal is denied, the denial notice will:

states the reason(s) why the claim you appealed is being denied;

refer to any specific Plan provision(s) on which the denial is based;

explain any voluntary appeal procedures offered by the Plan; and


Upon written request, MetLife will provide you free of charge with copies of documents, records and other information relevant to your claim.

Appealing Your Claim for Eligibility

If a claim for benefits is denied because NRECA decided that you, your spouse or your child is not eligible for coverage under the Plan, you may appeal this decision made by NRECA. An appeal may be filed by:

You;

Your Beneficiary, or the Beneficiary for your spouse or your child; or


34

Please note: There are specific response time periods for your claims and appeals. Below is the process for filing appeals regarding eligibility. If you need more information, please contact your benefits administrator.

You Can Appeal the Decision Regarding Eligibility

You, your Beneficiary or your authorized representative has 60 days from the date you receive the denial notice to request an appeal of NRECA’s decision.

To prepare your appeal, you may request from the Plan, free of charge, copies of all documents, records and other information related to your eligibility for coverage claim.

To submit your appeal:

Put your request in writing;

Include any written comments, records, documents and other information to support your appeal, even if you have already submitted these materials; and

Send to:

Appeals Administrator NRECA Attn: Life Insurance Product Advisor 4301 Wilson Blvd., Mailstop IFS7-333 Arlington, VA 22203


The Appeals Administrator has 60 days from the date your appeal is received to review it and make a decision. He or she is not the person who made the original decision to deny eligibility for coverage, nor is he or she directly supervised by the original decision-maker.

The Appeals Administrator will conduct a full and fair review of all documents and evidence you submitted to support your eligibility for coverage claim. He or she may consult with medical or vocational experts in order to make a decision. These medical or vocational experts are not the same experts consulted previously.

In some cases, the Appeals Administrator may need a 60-day extension. You will be notified that he or she needs more time to evaluate your appeal before the initial 60-day period is over.


State the specific reasons why the appeal is denied;

Refer to the specific Plan provisions on which the decision is based;

Explain your rights under ERISA’s claim and appeal rules; and

Explain your right to file a civil action under ERISA within 12 months.

This completes the Plan’s appeal process.

If your appeal of an eligibility for coverage claim is denied, you may voluntarily take part in one more review process called the Voluntary Final Appeal Process. If you do not choose to use the Voluntary Final Appeal Process, you may seek legal action.

35

How To Use the Voluntary Final Appeal Process

You may use this option if you wish to have the Plan’s Appeals Committee review your denied appeal of an eligibility of coverage claim. You have 60 days from the date you receive the notice that your appeal has been denied to request this review.

Using this Voluntary Final Appeal Process has no effect on your rights to any other benefits under the Plan or your rights to legal review.

Before you submit your request, please call 402-483-9200 if you have any questions or you want to request additional information about the Voluntary Final Appeal Process from the Appeals Committee.

To prepare your appeal, you may request from the Plan, free of charge, copies of all documents, records and other information related to your eligibility of coverage claim and appeal.

To submit your final appeal:

Put your request in writing;

Include any written comments, records, documents and other information to support your appeal, even if you have already submitted these materials; and

Send to:

Appeals Committee NRECA Attn: Senior VP, Insurance & Financial Services 4301 Wilson Blvd., Mailstop IFS7-333 Arlington, VA 22203

Appeals Committee Reviews Final Appeal

The Appeals Committee has 60 days from the date your final appeal is received to review it and make a decision.

The Appeals Committee is selected by the Senior Vice-President, Insurance & Financial Services, and has no financial or personal interest in the final appeal’s result.

The Appeals Committee will conduct a full and fair review of all documents and evidence you submitted to support your eligibility for coverage claim. It may consult with medical or vocational experts in order to make a decision. These medical or vocational experts are not the same experts consulted previously.

In some cases, the Appeals Committee may need a 60-day extension. You will be notified that it needs more time to evaluate your final appeal before the initial 60-day period is over.

If your Voluntary Final appeal is denied, the denial notice will:

State the specific reasons why the final appeal is denied;


Explain your rights under ERISA’s claim and appeal rules; and

Explain your right to file a civil action under ERISA within 12 months.

36

Chapter 9: Continuing Life Insurance Coverage

For purposes of continuing coverage, you may continue all or a part of your Plan benefits through either Conversion or Portability.

Conversion of Life Insurance

If all or a portion of your Life Insurance ends for any reasons stated below, you have the option to buy an individual policy of life insurance (“new policy”) from MetLife during the Application Period in accordance with the conditions and requirements of this section. This is referred to as the “option to convert.” Evidence of your insurability will not be required.

When You, Your Spouse, and Your Child Will Have the Option to Convert

You will have the option to convert when:

Your Life Insurance ends because:

o You cease to be in an eligible class of employees;

o Your employment ends, including due to retirement;

o The Plan ends, provided you have been covered by Life Insurance for at least 5

years; or

o The Plan is amended to end Life Insurance for an eligible class of which you are a

member, provided you have been covered by Life Insurance for at least 5 years; or

Your Life Insurance is reduced:

o On or after the date you attain age 70;

o Because you change from one eligible class of employees to another; or

o Due to an amendment of the Plan.

Your Spouse and Child Life Insurance Ends because:

o Child no longer meets the definition of Child under the Plan;

o You get divorced;

o You die; or

o Your coverage ends.

If you opt not to convert a reduction in the amount of your Life Insurance as described above, you will not have the option to convert that amount at a later date.

A reduction in the amount of your Life Insurance as a result of the payment of an accelerated benefit will not give rise to a right to convert under this section.

Application Period

If you opt to convert your Life Insurance for any of the reasons stated above, MetLife must receive a completed conversion application form from you within the Application Period described below.

If you are given Written notice of the option to convert within 15 days before or after the date your Life Insurance ends, the Application Period begins on the date that such Life Insurance ends and expires 31 days after such date.

If you are given Written notice of the option to convert more than 15 days after the date your Life Insurance ends, the Application Period begins on the date such Life Insurance ends and expires 15

37

days from the date of such notice. In no event will the Application Period exceed 91 days from the date your Life Insurance ends.

Option Conditions

The option to convert is subject to these conditions:

MetLife’s receipt within the Application Period of:

o Your Written application for the new policy; and

o The premium due for such new policy;

The premium rates for the new policy will be based on:

o MetLife’s rates then in use;

o The form and amount of insurance;

o Your class of risk; and

o Your attained age when your Life Insurance ends;

The new policy may be on any form then customarily offered by MetLife excluding term

insurance;

The new policy will be issued without an AD&D Insurance benefit, a continuation benefit,

an accelerated benefit option, a waiver of premium benefit or any other rider or additional

benefit; and

The new policy will take effect on the 32nd day after the date your Life Insurance ends; this

will be the case regardless of the duration of the Application Period.

Maximum Amount of the New Policy

If your Life Insurance ends due to the end of the Plan or the amendment of the Plan to end Life Insurance for an eligible class of which you are a member, the maximum amount of insurance that you may elect for the new policy is the lesser of:

The amount of your Life Insurance that ends under the Plan less the amount of Life

Insurance for which you become eligible under any Plan within 31 days after the date

insurance ends under the Plan; or

$2,000.

If your Life Insurance ends for any other reason, the maximum amount of insurance that you may elect for the new policy is the amount of your Life Insurance which ends under the Plan.

If You Die Within 31 Days After Your Life Insurance Ends

If you die within 31 days after your Life Insurance ends, Proof of your death must be sent to MetLife. When MetLife receives such Proof with the claim, MetLife will review the claim and if MetLife approves it, MetLife will pay the Beneficiary the amount of Life Insurance you were entitled to convert.

Portability For Life and AD&D Insurance

If your Portability Eligible Insurance or Portability Eligible Spouse or Child Insurance ends for any of the reasons stated below, you have the option to continue that insurance under another policy in

38

accordance with the conditions and requirements of this section. This is referred to as Porting. Evidence of your insurability will not be required.

For purposes of this subsection the term “Portability Eligible Insurance” refers to your Life Insurance and AD&D Insurance benefits shown in Chapter 2 for which the Portability Eligible Insurance is available.

If Insurance for your Spouse or Child is in effect, the term “Portability Eligible Spouse or Child Insurance” refers to your Life Insurance and AD&D Insurance shown in Chapter 2 for your Spouse or Child for which the Portability Eligible Spouse or Child Insurance is available.

When Porting is an Option

Porting may only be exercised by a request in Writing during the Request Period specified below.

If you choose not to Port, Life Insurance benefits may be converted in accordance with the section “Conversion” above. If you do not choose to convert or Port your Life and AD&D Insurance benefits, your coverage ends.

You may choose to Port if Portability Eligible Insurance and/or Portability Eligible Spouse

or Child Insurance ends because:

o You retire from active service with the Employer; or

o Your employment ends, due to a reason other than retirement; or

o You cease to be in a class that is eligible for such insurance; or

o The Plan is amended to end the Portability Eligible Insurance or Portability Eligible

Spouse or Child Insurance, unless such insurance is replaced by similar insurance under

another group insurance plan issued to the NRECA Group Benefits Program or its

successor; or

o This Plan has terminated, unless such insurance is replaced by similar insurance under

another group insurance policy issued to the NRECA Group Benefits Program or its

successor.

You may choose to Port the reduced amount of insurance if your Portability Eligible

Insurance is reduced due to:

o Your age; or

o An amendment to the Plan which affects the amount of insurance for your employee

classification.

Your Spouse may choose to Port if the Portability Eligible Spouse Insurance on his or her

own life ends because:

o You die;

o Your marriage ends in divorce or annulment; or

o There is a reduction due to your age provided that the former Spouse satisfies the

section “Additional Requirements for Spouse and Child Insurance” in Chapter 3.

Your Spouse may also Port Portability Eligible Child Insurance on your Child if your Spouse

Ports insurance on his or her own life and only if the Child’s coverage is ending.

Your Child may request to Port Portability Eligible Child Insurance on his or her own life if

that insurance ends because your Child no longer meets the definition of Child.

39

If a request is made to Port coverage, the Plan will issue a new individual policy which will explain the new insurance benefits. The insurance benefits under the new policy may not be the same as those that ended under this Plan.

A request to Port may be made, if on the date the Portability Eligible Insurance ended, the following requirements are met:

The Plan is in effect; and

With respect to any amount of Portability Eligible Life Insurance or Portability Eligible

Spouse or Child Life Insurance that is to be Ported, no application has been made to convert

that amount of insurance to an individual policy of life insurance as provided above in the

section “Conversion”.

Request Period

For you or a Spouse or Child to Port, MetLife must receive a completed request form within the Request Period as described below.

If Written notice of the option to Port is given within 15 days before or after the date such insurance ends, the Request Period:

Begins on the date the insurance ends, and

Expires 31 days after the date.

If Written notice of the option to Port is given more than 15 days after but within 91 days of the date such insurance ends, the Request Period:


Expires 45 days after the date of the notice.

If Written notice of the option to Port is not given within 91 days of the date such insurance ends, the Request Period:


Expires at the end of such 91 day period.

Chapter 10: General Information

Beneficiary

Keep in mind: for your loss of life, MetLife will pay benefits to your Beneficiary. For any other loss sustained by you, your Spouse, or your Child, MetLife will pay benefits to you.

You may designate a Beneficiary during your enrollment process. You may change your Beneficiary at any time. To do so, you must provide a Signed and dated, Written request to your Employer using a form satisfactory to MetLife. Your Written request to change the Beneficiary must be provided to the Employer within 30 days of the date you Sign such request.

You do not need the Beneficiary’s consent to make a change. When NRECA receives the change, it will take effect as of the date you Signed it. The change will not apply to any payment made in good faith by MetLife before the change request was recorded.

40

If two or more Beneficiaries are designated and their shares are not specified, they will share the insurance equally.

If there is no Beneficiary designated or no surviving designated Beneficiary at the time of your death, MetLife may determine the Beneficiary to be one or more of the following who survive you:

Your Spouse;

Your child(ren);

Your parent(s); or

Your sibling(s).

Instead of making payment to any of the above, MetLife may pay your estate. Any payment made in good faith will discharge MetLife’s liability to the extent of such payment.

If a Beneficiary is a minor or incompetent to receive payment, MetLife will pay that person’s court appointed property and estate guardianship or, MetLife will hold funds until the minor is of legal age.

Entire Contract

Your insurance is provided under a contract of group insurance with MetLife. The entire contract with MetLife and NRECA Group Benefits Program is made up of the following:

The Plan and its Exhibits, which include the SPD(s);

NRECA’s Group Benefits Program application; and

Any amendments and/or endorsements to the Plan.

Incontestability: Statements made by You

Any statement made by you will be considered a representation and not a warranty. MetLife will not use such statement to contest life insurance, reduce benefits or defend a claim unless the following requirements are met:

The statement is a Written application or enrollment form;

You have Signed the application or enrollment form; and

A copy of the application or enrollment form has been given to you or your Beneficiary.

MetLife will not use your statements which relate to insurability to contest life insurance after it has been in force for 2 years during your life. In addition, MetLife will not use such statements to contest an increase or benefit addition to such insurance after the increase or benefit has been in force for 2 years during your life.

Misstatement of Age

If your or your Spouse’s or Child’s age is misstated, the correct age will be used to determine if insurance is in effect and, as appropriate, MetLife will adjust the benefits and/or premiums.

Physical Exams

If a claim is submitted for insurance benefits other than life insurance benefits, MetLife has the right to ask the insured to be examined by a Physician(s) of MetLife’s choice as often as is reasonably necessary to process the claim. MetLife will pay the cost of such exam.

41

Autopsy

MetLife has the right to make a reasonable request for an autopsy where permitted by law. Any such request will set forth the reasons MetLife is requesting the autopsy.

State Life Insurance Notices

Notice For Residents of All States

LIFE INSURANCE BENEFITS WILL BE REDUCED IF AN ACCELERATED BENEFIT IS PAID DISCLOSURE: The Life Insurance accelerated benefit offered under this certificate is intended to qualify for favorable tax treatment under the Internal Revenue Code of 1986. If this benefit qualifies for such favorable tax treatment, the benefit will be excludable from your income and not subject to federal taxation. Tax laws relating to accelerated benefits are complex. You are advised to consult with a qualified tax advisor about circumstances under which you could receive an accelerated benefit excludable from income under federal law.

DISCLOSURE: Receipt of an accelerated benefit may affect your, your Spouse’s or your family’s eligibility for public assistance programs such as Medical Assistance (Medicaid), Aid to Families with Dependent Children (AFDC), Supplementary Social Security Income (SSI), and drug assistance programs. You are advised to consult with a qualified tax advisor and with social service agencies concerning how receipt of such payment will affect your, your Spouse’s and your family’s eligibility for public assistance.

Notices for Residents in Other States

If you reside in Arkansas, California, Georgia, Illinois, Massachusetts, Minnesota, Mississippi, New Mexico, North Carolina, Pennsylvania, Utah, Virginia, or Wisconsin – please visit cooperative.com for a copy of your applicable State Life Insurance Notice or ask your Benefits Administrator for a copy.

Chapter 11: Plan Information

Plan Name: The NRECA Group Benefits Program Plan Number: 501 Year Ends: December 31 Type of Plan: Group Term Life and Accidental Death & Dismemberment Insurance Plan Effective Date: January 1, 2012

Underwritten by: Metropolitan Life Insurance Company 501 US Highway 22 P.O. Box 6891 Bridgewater, NJ 08807

Plan Sponsor: National Rural Electric Cooperative Association 4301 Wilson Boulevard Arlington, VA 22203-1860

Plan Sponsor Employer Identification Number: 53-0116145

The Insurance & Financial Services Department of the National Rural Electric Cooperative Association (NRECA) performs the general administrative duties. The names of persons who have the decision-making responsibilities are on file at the NRECA Insurance & Financial Services Department.

42

Plan Administrator: Senior Vice-President Insurance & Financial Services National Rural Electric Cooperative Association

4301 Wilson Boulevard Arlington, VA 22203-1860 Telephone number 703.907.5500

Plan Administrator Employer Identification Number: 54-2072724

In addition to the Senior Vice-President of the Insurance and Financial Services Department, the benefits administrator is the person with Plan Administrator responsibilities for your Employer:

OZARK BORDER ELECTRIC COOPERATIVE P.O. BOX 400 POPLAR BLUFF, MO 63902-0400

Employer Identification Number: 43-0445644

The agent for service of process receives all legal notices on behalf of the Plan Sponsor regarding claims or suits filed with respect to the Plans.

Agent for service of process:

Senior Vice-President Insurance & Financial Services Department National Rural Electric Cooperative Association 4301 Wilson Boulevard Arlington, VA 22203-1860

In addition to the agent for service of legal process, service may also be made upon the Plan Trustee.

Plan Trustee, NRECA Group Benefits Trust:

State Street Bank and Trust Company 225 Franklin Street Boston, MA 02101

Claim Adjudicator: Metropolitan Life Insurance Company Group Life Claims P.O. Box 6100 Scranton, PA 18505-6100

Chapter 12: Administrative Information

Not a Contract of Employment

This Plan must not be construed as a contract of employment and does not give any Employee a right of continued employment. Nor may the Plan be construed as a guarantee of other benefits from your Employer.

Non-Assignment of Benefits

You cannot assign, pledge, borrow against or otherwise promise any benefit payable under the Plan before you receive it.

43

Right of Recovery of Overpayment

If it is later determined that you received an overpayment or a payment was made in error, you will be required to refund the overpayment to the Plan. The Plan has the right to recover overpayments as a result of, but not limited to those:

Due to fraud;

Due to any error the Plan makes in processing a claim; and

Benefits paid after the death of the Employee.

If you do not refund the overpayment, the Plan reserves the right to bring legal action against you to recover the overpayment and/or to offset future benefit payments until the overpayment is recouped. You will be notified if a mistake is found.

Amendment or Termination

This Plan may be amended or terminated at any time, for any reason, by action of the Plan Administrator or your Employer. This includes the right to change the cost of coverage. These changes may be made with or without advance notice to Plan participants. However, your rights to claim benefits for the period prior to the termination or amendment will not be affected if such benefit is payable under the Plan as in effect before the Plan is terminated or amended.

Severability

If any provision of this Plan is held invalid, the invalid provision does not affect the remaining parts of this Plan. The Plan is construed and enforced as if the invalid provision had never been included.

Additional Procedures

The Plan Administrator may promulgate any rules, regulations or procedures not covered by this Plan that may be necessary for the proper administration of this Plan.

Chapter 13: Federal Laws Impacting This Plan

Statement of ERISA Rights

Your Rights

As an Employee in the Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants shall be entitled to:

Receive Information About Your Plan and Benefits

You have the right to:

Examine, without charge, at the Plan Administrator’s office and at other specified locations, such as worksites, all documents governing the Plan, including insurance contracts, if any, and a copy of the latest annual report (Form 5500 series), if any, filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.

Obtain, upon request to the Plan Administrator, copies of documents governing the operation of the Plan, including insurance contracts and copies of the latest annual report

44

(Form 5500 Series) and updated summary plan description (SPD). The Plan Administrator may make a reasonable charge for the copies.

Receive a summary of the Plan’s annual Form 5500, if any is required by ERISA to be prepared, in which case NRECA, as Plan Administrator, is required by law to furnish each participant with a copy of this summary annual report.

Duties of Plan Fiduciaries

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Employee benefit plan. The people who operate your Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your Employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit or exercising your rights under ERISA.

Enforce Your Rights

If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps that you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report (Form 5500), if any, from the Plan and do not receive them within 30 days, you may file suit in federal court. In such case, the court may require the Plan Administrator to provide the materials and pay you up to $110 per day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored in whole or in part, and if you have exhausted the claims procedures available to you under the Plan, you may file suit in a state or federal court.

If it should happen that Plan fiduciaries misuse the Plan’s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Please remember that you may not file a lawsuit in federal or state court to enforce your rights until you have exercised, and exhausted, all mandatory administrative claim and appeal rights described in the Plan and in this document. Any suit for benefits must be brought within one year from the date the final appeal determination was made.

Assistance with Your Questions

If you have any questions about your Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor (listed in your telephone directory) or contact the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

45

Chapter 14: Definitions

As used in this SPD, the terms listed below will have the meanings set forth below. When defined terms are used in this SPD, they will appear with initial capitalization. The plural use of a term defined in the singular will share the same meaning.

Actively at Work or Active Work means that you are performing all of the usual and customary duties of your job on a full-time basis. This must be done at:

the Employer’s place of business;

an alternate place approved by the Employer; or

a place to which the Employer’s business requires you to travel.

You will be deemed to be Actively at Work during weekends or Employer approved vacations, holidays or business closures if you were Actively at Work on the last scheduled work day preceding such time off.

Air Bag means an inflatable restraint device that:

Meets published United States government safety standards;

Is properly installed by the car manufacturer; and

Is not altered after the installation.

Base Annual Earnings means your gross annual rate of pay as determined by your Employer, excluding overtime and other extra pay.

Beneficiary means the person(s) to whom MetLife will pay insurance as determined in accordance with Chapter 11.

Child or Children means the following:

For Life Insurance, your natural child from live birth, your adopted child (including a child from the date of placement with the adopting parents until the legal adoption), your stepchild, your unmarried foster child; or any child under your custody and care who, in each case, is under age 26 and supported by you.

The term does not include any person who:

is insured under the Plan as an employee.

For Texas residents Child means the following for Life Insurance:

Your natural child from live birth, adopted child; stepchild, or unmarried foster child who resides with you and is supported by you, or a child who resides with you, who is supported by you and for whom you are the legally appointed guardian; and who, in each case, is under age 26. The term also includes your grandchild who is under age 26 and who was able to be claimed by you as a dependent for Federal income tax purposes at the time you applied for Life Insurance.

A child will be considered your adopted child during the period you are party to a suit in which you are seeking the adoption of the child.


is insured under the Plan as an employee.

46

For Texas residents Child means the following for AD&D Insurance:

Your natural child from live birth; adopted child or stepchild or unmarried foster child who resides with you, is supported by you or who is under age 26. The term also includes your grandchild who is under age 26, unmarried and who was able to be claimed by you as a dependent for Federal income tax purposes at the time you applied for AD&D Insurance.


The term does not include any person who is insured under the Plan as an employee.

For New Mexico residents Child means the following for AD&D Insurance:

Your natural child from live birth, adopted child (including a child from the date of placement with the adopting parents until the legal adoption), stepchild or unmarried foster child who reside with you, is supported by you or is under age 26.

An adopted child includes a child placed in your physical custody for purpose of adoption. If prior to completion of the legal adoption the child is removed from your custody, the child’s status as an adopted child will end.

No natural child from live birth, adopted child or stepchild will be denied AD&D Insurance because such child was born out of wedlock, is not residing with you, or is not claimed by you as a deduction for Federal Income Taxes.

The Term does not include any person who is insured under the Plan as an employee.

For Utah residents Child means the following for AD&D Insurance:

Your natural child from live birth, adopted child stepchild who is unmarried or unmarried foster child who reside with you, is supported by you and under age 26.


The term does not include any person who is insured under the Plan as an employee.

Disability or Disabled means a status of Disability met due to an injury or sickness where:

You are unable to perform the duties of your regular job; or

You are unable to perform any other job for which you are fit by education, training or experience.

Child Care Center means a facility that:

Is operated and licensed according to the law of the jurisdiction where it is located; and

Provides care and supervision for children in a group setting on a regularly scheduled and

daily basis.

Common Carrier means a government regulated entity that is in the business of transporting fare paying passengers.

The term does not include:

chartered or other privately arranged transportation;

taxies; or

47

limousines.

Contributory Insurance means insurance for which the Employer requires you to pay any part of the premium.

Contributory Insurance includes: Supplemental Life Insurance, Supplemental AD&D Insurance and Spouse or Child Life Insurance.

Employer means the organization, association, cooperative, system, entity, etc., from which you receive a salary for performing your job responsibilities and through which you receive the benefits under the Plan.

Full-Time means Active Work on the Employer’s regular work schedule for the eligible class of employees to which you belong.

Hospital means a facility which is licensed as such in the jurisdiction in which it is located and:

provides a broad range of medical and surgical services on a 24 hour a day basis for injured

and sick persons by or under the supervision of a staff of Physicians; and

provides a broad range of nursing care on a 24 hour a day basis by or under the direction of

a registered professional nurse.

Hospitalized means:

admission for inpatient care in a Hospital;

receipt of care in the following:

o a hospice facility;

o an intermediate care facility; or

o a long term care facility.

Receipt of the following treatment, wherever performed:

o chemotherapy;

o radiation therapy; or

o dialysis.

Noncontributory Insurance means insurance for which the Employer does not require you to pay any part of the premium.

Non-Medical Issue Amount means a level of insurance coverage that is guaranteed without medical evidence of insurability and available within 31 days when first offered or during a Qualifying Event (see “Chapter 3”).

Normal Retirement Age means the age at which you are eligible for a full pension from your Employer. For purposes of the life premium waiver, if you are Disabled before the Normal Retirement Age and your Employer has a 30-year/age 62 retirement plan, the Normal Retirement Age is age 62, whether or not you have completed 30 years of participation.

Passenger Car means any validly registered four-wheel private passenger car, four-wheel drive vehicle, sports-utility vehicle, pick-up truck or mini-van. It does not include any commercially licensed car, any private car being used for commercial purposes, or any vehicle used for recreational or professional racing.

48

Physician means:

a person licensed to practice medicine in the jurisdiction where such services are performed;

or

any other person whose services, according to applicable law, must be treated as Physician’s

services for purposes of the Plan. Each such person must be licensed in the jurisdiction

where he performs the service and must act within the scope of that license. He must also be

certified and/or registered if required by such jurisdiction.

The term does not include:

You;

Your Spouse; or

any member of your immediate family, including your and/or your Spouse’s:

o parents;

o children (natural, step or adopted);

o siblings;

o grandparents; or

o grandchildren.

Proof means Written evidence satisfactory to MetLife that a person has satisfied the conditions and requirements for any benefit described in this SPD. When a claim is made for any benefit described in this SPD, Proof must establish:

the nature and extent of the loss or condition;

MetLife’s obligation to pay the claim; and

the claimant’s right to receive payment.

Proof must be provided at the claimant’s expense.

Seat Belt means any restraint device that:

Meets published United States Government safety standards;

Is properly installed by the car manufacturer; and

Is not altered after the installation.

The term includes any child restraint device that meets the requirements of state law.

Statement of Health (SOH) means the form you or your spouse must complete to determine if you, your spouse, or your children can be insured by the Plan. See “Chapter 4” for more information on evidence of insurability. In some cases MetLife may ask for additional information, such as a Physician’s report. If the benefits level you choose is denied due to the SOH, you will automatically be enrolled in the highest benefit amount that does not require a SOH if first time offered or qualified event. Otherwise you will remain with what was in force prior to the SOH. The benefit amount that does not require a SOH is also called the Non-Medical Issue Amount.

49

Signed means any symbol or method executed or adopted by a person with the present intention to authenticate a record, which is on or transmitted by paper or electronic media which is acceptable to MetLife and consistent with applicable law.

Spouse means your lawful spouse.


lives outside of the United States or Canada.

Written or Writing means a record which is on or transmitted by paper or electronic media which is acceptable to MetLife and consistent with applicable law.

NRECA Retired Life Insurance Plan ___________________________________________________________________________

SUMMARY PLAN DESCRIPTION

For:

OZARK BORDER ELECTRIC COOPERATIVE

01-26033-003

EFFECTIVE DATE: January 1, 2012

Introduction

This document is a Summary Plan Description (SPD) providing you with a summary of the key provisions of the NRECA Retired Life Insurance Plan(referred to as the “Plan” in this document) for OZARK BORDER ELECTRIC COOPERATIVE. This Plan is a component plan of the NRECA Group Benefits Program. In the pages that follow, you will find information on the benefits provided by the Plan.

If you are eligible to participate in the Plan, you may choose coverage for yourself and any eligible dependents.

Each participant in this Plan is responsible for reading this SPD and related materials completely and complying with all rules and Plan provisions.

While the Plan’s provisions determine what services and supplies are eligible for benefits, you and your health care provider have ultimate responsibility for determining appropriate treatment and care.

If the terms of this SPD conflict with the terms of the governing plan document, then the terms of the governing plan document will control, rather than this SPD.

Table of Contents

Chapter 1: Contacts ...................................................................................................................................... 5

Chapter 2: Benefit Highlights Under the Plan ......................................................................................... 5

Retired Life Insurance Benefit Highlights............................................................................. 5

Chapter 3: Eligibility and Participation Information ............................................................................... 6

Eligibility for Participation ...................................................................................................... 6

Date Your Insurance Ends ...................................................................................................... 7

Chapter 4: Retired Life Insurance Benefits .............................................................................................. 7

Benefit Payment ........................................................................................................................ 7

Exclusions .................................................................................................................................. 7

Chapter 5: Accelerated Benefit Option (ABO) Benefits ........................................................................ 7

Requirements For Payment of an Accelerated Benefit ....................................................... 8

Proof of Your Terminal Illness .............................................................................................. 8

Accelerated Benefit Amount ................................................................................................... 8

Effect of Payment of an Accelerated Benefit ....................................................................... 8

Date Your Option to Accelerate Benefits Ends .................................................................. 9

Chapter 6: Claims and Appeals Procedures.............................................................................................. 9

Claims for Life Insurance Benefits ......................................................................................... 9

Appealing Your Claim With MetLife ..................................................................................... 9

MetLife Reviews Your Claim for Benefits .......................................................................... 10

You May Appeal the Initial Determination ........................................................................ 10


Appealing Your Claim for Eligibility ................................................................................... 11

You Can Appeal the Decision Regarding Eligibility ......................................................... 11

Your Beneficiary's Appeal is Reviewed ............................................................................... 11

How To Use the Voluntary Final Appeal Process ............................................................. 12

Appeals Committee Reviews Final Appeal ......................................................................... 12

Chapter 7: Continuing Life Insurance Coverage ................................................................................... 13

Conversion ............................................................................................................................... 13

When You Will Have the Option to Convert .................................................................... 13

Portability For Life Insurance ............................................................................................... 15

Request Period ........................................................................................................................ 15

Chapter 8: General Information............................................................................................................... 16

Beneficiary ................................................................................................................................ 16

Entire Contract........................................................................................................................ 16

Physical Exams ........................................................................................................................ 17

Autopsy .................................................................................................................................... 17

State Life Insurance Notices ................................................................................................. 17

Chapter 9: Plan Information ..................................................................................................................... 17

Chapter 10: Administrative Information................................................................................................... 19

Not a Contract of Employment ........................................................................................... 19

Non-Assignment of Benefits ................................................................................................ 19

Right of Recovery of Overpayment ..................................................................................... 19

Amendment or Termination ................................................................................................. 19

Severability ............................................................................................................................... 19

Additional Procedures ............................................................................................................ 19

Chapter 11: Federal Laws Impacting This Plan ....................................................................................... 19

Statement of ERISA Rights .................................................................................................. 19

Chapter 12: Definitions ............................................................................................................................... 21

5

Chapter 1: Contacts

Information about:

Claims for Benefits

MetLife Group Life Claims P.O. Box 6100 Scranton, PA 18505

1-800-638-6420

Information about:

Eligibility

Enrollment

When Coverage Begins or Ends

Cost of Coverage

General Questions

Changing Your Beneficiary

Benefits Administrator


Chapter 2: Benefit Highlights Under the Plan

This chapter includes the highlights of your Retired Life Insurance benefits under the Plan. For further information about these benefits, other benefits, and Plan exclusions – please read Chapter 4.

You will only be insured for the benefits:

for which you become and remain eligible;

for which you elect, if subject to election; and

which are in effect.

Retired Life Insurance Benefit Highlights


$5,000 Life insurance benefit equal to $5,000

Retiree


Retiree


Retiree

6


Retiree

Retired Life Insurance benefit prior to 2008

If you retired before your Employer’s renewal date in 2008, your Retired Life Insurance benefit is the same as it was prior to the 2008 renewal date.

You will continue coverage under the pre-2008 benefit as long as you are eligible.

Talk to your Benefits Administrator.

Minimum Retired Life Insurance Benefit

$5,000

Maximum Retired Life Insurance Benefit

$20,000

You may elect an Accelerated Benefit Option (ABO) of up to 80% of your Retired Life Insurance amount, not to exceed $16,000. Keep in mind: ABO is not available if the value of your life insurance coverage is under $10,000.

If your Employer pays for an amount of Retired Life Insurance, you may elect an additional amount of Retired Life Insurance up to a combined maximum of $20,000.

Even if your Employer does not pay for an amount of Retired Life Insurance, you may elect one of the 4 benefit levels of Retired Life Insurance noted in the chart above up to a maximum of $20,000.

Chapter 3: Eligibility and Participation Information

Eligibility for Participation

Eligible Class(es)

You are eligible for insurance under this Plan if you were:

Participating in the NRECA Group Term Life and AD&D Insurance Plan;

Covered by life insurance under such plan on the day immediately preceding the date of your retirement; and

Have retired in accordance with your Employer’s retirement plan.

Ineligible Class(es)

The following classifications of retired employees are not eligible for coverage:

This Plan does not have any excluded job classifications, positions or titles.

Date You Are Eligible For Insurance

7

You will be eligible for insurance described in this SPD on the day you retire.

If you Become a Director

If you enroll in the NRECA Directors Life and AD&D Insurance Plan, you will no longer be eligible for insurance benefits as a retired employee under this Plan (see “Continuing Your Coverage”). If you choose to enroll in the NRECA’s Directors AD&D Only Insurance Plan, you are eligible for insurance benefits as a retired employee under this Plan.

Keep in mind: If you enroll in the NRECA Directors Life and AD&D Insurance Plan, you will not be eligible for coverage under this Plan after your directorship ends.

Enrollment Process

If you are eligible for insurance under this Plan, you may enroll for such insurance by completing the required process. If you enroll in Contributory Insurance, you will be notified by the Employer regarding how much you will be required to contribute.

Date Your Insurance Ends

Your insurance will end on the earliest of:


the date insurance ends for your retiree classification; or

the end of the period for which the last premium has been paid for you (or by you).

Please refer to the Chapter “Continuing Your Coverage” for information on the options to continue to an individual policy of life insurance if your Retired Life Insurance ends.

Chapter 4: Retired Life Insurance Benefits

Benefit Payment

Your Beneficiary will receive payment of your Retired Life Insurance benefits of five thousand dollars ($5,000) or more through an interest-bearing account with check-writing privileges known as a “Total Control Account (TCA)” that is guaranteed by MetLife. The TCA preserves your Beneficiary’s right to choose among other settlement options offered by MetLife at the time that the TCA is established.

Exclusions

There are no exclusions under this Plan.

Chapter 5: Accelerated Benefit Option (ABO) Benefits

For purposes of this section, the term “ABO Eligible Life Insurance” refers to each of your Retired Life Insurance benefits for which the ABO is shown as available in Chapter 2.

If you become Terminally Ill, you or your legal representative have the option to request MetLife to pay ABO Eligible Life Insurance before your death. This is called an accelerated benefit. The request must be made while ABO Eligible Life Insurance is in effect.


8

For residents of Texas only:


Requirements For Payment of an Accelerated Benefit

Subject to the conditions and requirements of this section, MetLife will pay an accelerated benefit to you or your legal representative if:

MetLife has received Proof that you are Terminally Ill.

MetLife will only pay an accelerated benefit for each ABO Eligible Life Insurance benefit once.

Proof of Your Terminal Illness

MetLife will require the following Proof of your Terminal Illness:

A completed accelerated benefit claim form;

A Signed Physician’s certification that you are Terminally Ill; and

An examination by a Physician of MetLife’s choice, at MetLife’s expense, if MetLife requests

it.

You or your legal representative should contact the Employer to obtain a claim form and information regarding the accelerated benefit.

Upon MetLife’s receipt of your request to accelerate benefits, MetLife will send you a letter with information about the accelerated benefit payment you requested. MetLife’s letter will describe the amount of the accelerated benefits MetLife will pay and the amount of Retired Life Insurance remaining after the accelerated benefit is paid. The remaining benefit will be paid to your Beneficiary upon your death.

Accelerated Benefit Amount

MetLife will pay an accelerated benefit up to the percentage shown in Chapter 2 for each ABO Eligible Life Insurance benefit in effect for you, subject to the following:

Maximum Accelerated Benefit Amount. The maximum amount MetLife will pay for each ABO Eligible Life Insurance benefit is show in Chapter 2.

Previous Conversion of an ABO Eligible Life Insurance Benefit. MetLife will not pay an accelerated benefit for any amount of ABO Eligible Life Insurance which you previously converted under Chapter 8.

MetLife will pay the accelerated benefit in one sum unless you or your legal representative select another payment mode.

Effect of Payment of an Accelerated Benefit

On premium for Your Life Insurance. After MetLife pays the accelerated benefit, any premium you are required to pay will be based upon the amount of your Retired Life Insurance remaining after the accelerated benefit is paid.

On Your Life Insurance at Your death. The amount of Retired Life Insurance that MetLife will pay at your death will be decreased by the amount of the accelerated benefit paid by MetLife.

9

On Your Life Insurance at conversion/port. The amount to which you are entitled to convert/port under Chapter 8 will be decreased by the amount of the accelerated benefit paid by MetLife.

Date Your Option to Accelerate Benefits Ends

The accelerated benefit option will end on the earliest of:

The date the ABO Eligible Life Insurance ends;

The date you or your legal representative have accelerated all ABO Eligible Life Insurance

benefits; or

Upon your death.

Chapter 6: Claims and Appeals Procedures

Your Benefit Administrator at your Employer will report all deaths and receive a claim packet. Obtain the claim packet from your Benefits Administrator and fill it out carefully. Return the completed claim form with the required Proof to the Employer. The Employer will certify your insurance under the Plan and send the certified claim form and Proof to MetLife.

When MetLife receives the claim form and Proof, MetLife will pay benefits subject to the terms and provisions of this SPD and the Plan.

Claims for Life Insurance Benefits

When a claimant files a claim for Life Insurance benefits, Proof should be sent to MetLife as soon as is reasonably possible after the death of an insured.

Time Limit on Legal Actions

A legal action on a claim may only be brought against MetLife during a certain period. This period begins 60 days after the date Proof is filed and ends 3 years after the date such Proof is required.

Proof

If you die, Proof of your death must be sent to MetLife. When MetLife receives such Proof with the claim, MetLife will review the claim and, if MetLife approves it, will pay the Beneficiary the Retired Life Insurance in effect on the date of your death.

Payment Options

MetLife will pay the Retired Life Insurance in one sum. Other modes of payment may be available upon request. For details, call MetLife’s toll free number 1-800-638-6420.

Appealing Your Claim With MetLife

If MetLife denies a claim for benefits for you, this decision may be appealed, following MetLife’s appeals process. Appeals may be filed by:

You,

Your Beneficiary, or


10

An authorized representative is a person you authorize in writing to act on your behalf. An authorized representative may not be a doctor or other health care provider.

Please note: There are specific response time periods for your claims and appeals. Below is the process for reviewing claims and filing claims or appeals. If you need more information, please contact your benefits administrator.

MetLife Reviews Your Claim for Benefits

After MetLife receives your claim for benefits under this Plan, MetLife will review your claim and notify you within 90 days of the date it receives your claim whether your claim is approved or denied.

In some cases, MetLife may need a 90-day extension. You will be notified that it needs more time to evaluate your claim before the initial 90-day period is over.

If MetLife denies your claim in whole or in part, the denial notice will:

state the reason why your claim was denied;

refer to the specific Plan provision(s) on which the denial is based;

describe any additional information needed and why this information is needed;

explain the Plan review procedures and time limits; and


Upon your written request, MetLife will provide you, free of charge, with copies of relevant documents, records and other information.

You May Appeal the Initial Determination

You, your Beneficiary or your authorized representative may request a review of your claim by MetLife within 60 days after the date you receive the denial notice.

When requesting a review:

submit your request in writing;

state the reason you, your Beneficiary or authorized representative believe the claim was improperly denied;

include any written comments, documents, records or other information to support your appeal, even if you have already submitted these materials; and

send it to “Group Insurance Claims Review” at the address of the MetLife office which processed the claim.


MetLife has 60 days from the date it receives your request for review to

re-evaluate all of the information;

conduct a full and fair review of the claim; and

notify you, your Beneficiary or authorized representative of its decision.

In some cases, MetLife may need a 60-day extension. You, your Beneficiary or authorized representative will be notified if more time is needed to evaluate your appeal before the initial 60-day period is over.

11


states the reason(s) why the claim you appealed is being denied;

refer to any specific Plan provision(s) on which the denial is based;

explain any voluntary appeal procedures offered by the Plan; and


Upon written request, MetLife will provide you free of charge with copies of documents, records and other information relevant to your claim.

Appealing Your Claim for Eligibility

If a claim for benefits is denied because NRECA decided that you were not eligible for coverage under the Plan, your Beneficiary may appeal this decision made by NRECA.

Please note: There are specific response time periods for your claims and appeals. Below is the process for filing appeals regarding eligibility. If you need more information, please contact your benefits administrator.

You Can Appeal the Decision Regarding Eligibility

Your Beneficiary has 60 days from the date of receipt of the denial notice to request an appeal of NRECA’s decision.

To prepare the appeal, your Beneficiary may request from the Plan, free of charge, copies of all documents, records and other information related to eligibility for coverage claim.

To submit the appeal:

Put the request in writing;

Include any written comments, records, documents and other information to support the appeal, even if they have already submitted these materials; and

Send to:

Appeals Administrator NRECA Attn: Life Insurance Product Advisor 4301 Wilson Blvd., Mailstop IFS7-333 Arlington, VA 22203

Your Beneficiary's Appeal is Reviewed

The Appeals Administrator has 60 days from the date the appeal is received to review it and make a decision. He or she is not the person who made the original decision to deny eligibility for coverage, nor is he or she directly supervised by the original decision-maker.

The Appeals Administrator will conduct a full and fair review of all documents and evidence submitted to support the eligibility for coverage claim. He or she may consult with medical or vocational experts in order to make a decision. These medical or vocational experts are not the same experts consulted previously.

In some cases, the Appeals Administrator may need a 60-day extension. Your Beneficiary will be notified that he or she needs more time to evaluate your appeal before the initial 60-day period is over.

12

If the appeal is denied, the denial notice will:

State the specific reasons why the appeal is denied;


Explain your Beneficiary's rights under ERISA’s claim and appeal rules; and

Explain your Beneficiary's right to file a civil action under ERISA within 12 months.

This completes the Plan’s appeal process.

If the appeal of an eligibility of coverage claim is denied, your Beneficiary may voluntarily take part in one more review process called the Voluntary Final Appeal Process. If they do not choose to use the Voluntary Final Appeal Process, your Beneficiary may seek legal action.

How To Use the Voluntary Final Appeal Process

Your Beneficiary may use this option if they wish to have the Plan’s Appeals Committee review their denied appeal of an eligibility of coverage claim. Your Beneficiary has 60 days from the date they receive the notice that the appeal has been denied to request this review.

Using this Voluntary Final Appeal Process has no effect on your Beneficiary's rights to any other benefits under the Plan or their rights to legal review.

Before the Beneficiary submits the request, please call 402-483-9200 if they have any questions or they want to request additional information about the Voluntary Final Appeal Process from the Appeals Committee.

To prepare the appeal, your Beneficiary may request from the Plan, free of charge, copies of all documents, records and other information related to the eligibility of coverage claim and appeal.

To submit the final appeal:

Put the request in writing;

Include any written comments, records, documents and other information to support the appeal, even if they have already submitted these materials; and

Send to:

Appeals Committee NRECA Attn: Senior VP, Insurance & Financial Services 4301 Wilson Blvd., Mailstop IFS7-333 Arlington, VA 22203

Appeals Committee Reviews Final Appeal

The Appeals Committee has 60 days from the date the final appeal is received to review it and make a decision.

The Appeals Committee is selected by the Senior Vice-President, Insurance & Financial Services, and has no financial or personal interest in the final appeal’s result.

The Appeals Committee will conduct a full and fair review of all documents and evidence submitted to support the eligibility for coverage claim. It may consult with medical or vocational experts in

13

order to make a decision. These medical or vocational experts are not the same experts consulted previously.

In some cases, the Appeals Committee may need a 60-day extension. Your Beneficiary will be notified that it needs more time to evaluate your final appeal before the initial 60-day period is over.

If your Beneficiary's Voluntary Final appeal is denied, the denial notice will:

State the specific reasons why the final appeal is denied;


Explain your Beneficiary's rights under ERISA’s claim and appeal rules; and

Explain your Beneficiary's right to file a civil action under ERISA within 12 months.

Chapter 7: Continuing Life Insurance Coverage

For purposes of continuing coverage, you may continue all or a part of your Plan benefits through either Conversion or Portability.

Conversion

If all or a portion of your Life Insurance ends for any reasons stated below, you have the option to buy an individual policy of life insurance (“new policy”) from MetLife during the Application Period in accordance with the conditions and requirements of this section. This is referred to as the “option to convert.” Evidence of your insurability will not be required, however you have the option to complete an Statement of Health.

When You Will Have the Option to Convert

You will have the option to convert when:

Your Retired Life Insurance ends because:

o You cease to be in an eligible class of retiree;

o The Plan ends, provided you have been insured for Life Insurance for at least 5

years; or

o The Plan is amended to end Life Insurance for an eligible class of which you are a

member, provided you have been insured for Life Insurance for at least 5 years; or

Your Life Insurance is reduced:

o Because you change from one eligible class to another; or

o Due to an amendment of the Plan.

If you opt not to convert a reduction in the amount of your Life Insurance as described above, you will not have the option to convert that amount at a later date.

A reduction in the amount of your Life Insurance as a result of the payment of an accelerated benefit will not give rise to a right to convert under this section.

Application Period

14

If you opt to convert your Life Insurance for any of the reasons stated above, MetLife must receive a completed conversion application form from you within the Application Period described below.

If you are given Written (see “Definitions”) notice of the option to convert within 15 days before or after the date your Life Insurance ends, the Application Period begins on the date that such Life Insurance ends and expires 31 days after such date.

If you are given Written notice of the option to convert more than 15 days after the date your Life Insurance ends, the Application Period begins on the date such Life Insurance ends and expires 15 days from the date of such notice. In no event will the Application Period exceed 91 days from the date your Life Insurance ends.

Option Conditions

The option to convert is subject to these conditions:

MetLife’s receipt within the Application Period of:

o Your Written application for the new policy; and

o The premium due for such new policy;

The premium rates for the new policy will be based on:

o MetLife’s rates then in use;

o The form and amount of insurance;

o Your class of risk; and

o Your attained age when your Life Insurance ends;

The new policy may be on any form then customarily offered by MetLife excluding term

insurance; and

The new policy will take effect on the 32nd day after the date your Life Insurance ends; this

will be the case regardless of the duration of the Application Period.

Maximum Amount of the New Policy

If your Life Insurance ends due to the end of the Plan or the amendment of the Plan to end Life Insurance for an eligible class of which you are a member, the maximum amount of insurance that you may elect for the new policy is the lesser of:

The amount of your Life Insurance that ends under the Plan less the amount of life

insurance for which you become eligible under any the Plan within 31 days after the date

insurance ends under the Plan; or

$2,000.

If your Life Insurance ends for any other reason the maximum amount of insurance that you may elect for the new policy is the amount of your Life Insurance which ends under the Plan.

If You Die Within 31 Days After Your Life Insurance Ends

If you die within 31 days after your Life Insurance ends, Proof of your death must be sent to MetLife. When MetLife receives such Proof with the claim, MetLife will review the claim and if MetLife approves it, MetLife will pay the Beneficiary the amount of Life Insurance you were entitled to convert.

15

Portability For Life Insurance

If your Portability Eligible Insurance ends for any of the reasons stated below, you have the option to continue that insurance under another policy in accordance with the conditions and requirements of this section. This is referred to as Porting. Evidence of your insurability will not be required, however you will have the option to complete an Statement of Health.

For purposes of this subsection the term “Portability Eligible Insurance” refers to your Life Insurance benefits shown in Chapter 2 for which the Portability Eligible Insurance is available.

When Porting is an Option

Porting may only be exercised by a request in Writing during the Request Period specified below.

If you choose not to Port, Life Insurance benefits may be converted in accordance with the section above “Conversion”. If you do not choose to convert or Port your Life Insurance benefits, your coverage ends.

You may choose to Port if Portability Eligible insurance ends because:

o You cease to be in a class that is eligible for such insurance; or

o The Plan is amended to end the Portability Eligible Insurance, unless such insurance is

replaced by similar insurance under another group insurance plan issued to the NRECA

Group Benefits Program or its successor; or

o This Policy has ended, unless such insurance is replaced by similar insurance under

another group insurance policy issued to the NRECA Group Benefits Program or its

successor.

You may choose to Port the reduced amount of insurance if your Portability Eligible

Insurance is reduced due to:

o An amendment to the Plan which affects the amount of insurance for your employee

classification.

If a request is made under this subsection, the Plan will issue a new Individual Policy which will explain the new insurance benefits. The insurance benefits under the new Policy may not be the same as those that ended under this Plan.

A request under this subsection may be made, if on the date the Portability Eligible Insurance ended, the following requirement is met:

The Plan is in effect.

Request Period

For you to Port, MetLife must receive a completed request form within the Request Period as described below.

If Written notice of the option to Port is given within 15 days before or after the date such insurance ends, the Request Period:

Begins on the date the insurance ends; and

Expires 31 days after the date.

16

If Written notice of the option to Port is given more than 15 days after but within 91 days of the date such insurance ends, the Request Period:


Expires 45 days after the date of the notice.

If Written notice of the option to Port is not given within 91 days of the date such insurance ends, the Request Period:


Expires at the end of such 91 day period.

Chapter 8: General Information

Beneficiary

Keep in mind: for your loss of life, MetLife will pay benefits to your Beneficiary.

You may designate a Beneficiary during your enrollment process. You may change your Beneficiary at any time. To do so, you must provide a Signed and dated, Written request to your Employer using a form satisfactory to MetLife. Your Written request to change the Beneficiary must be provided to the Employer within 30 days of the date you Sign such request.

You do not need the Beneficiary’s consent to make a change. When NRECA receives the change, it will take effect as of the date you Signed it. The change will not apply to any payment made in good faith by MetLife before the change request was recorded.

If two or more Beneficiaries are designated and their shares are not specified, they will share the insurance equally.

If there is no Beneficiary designated or no surviving designated Beneficiary at the time of your death, MetLife may determine the Beneficiary to be one or more of the following who survive you:

Your Spouse;

Your child(ren);

Your parent(s); or

Your sibling(s).

Instead of making payment to any of the above, MetLife may pay your estate. Any payment made in good faith will discharge MetLife’s liability to the extent of such payment.

If a Beneficiary is a minor or incompetent to receive payment, MetLife will pay that person’s court appointed property and estate guardianship or, MetLife will hold funds until the minor is of legal age.

Entire Contract

Your insurance is provided under a contract of group insurance with MetLife. The entire contract with MetLife and NRECA Group Benefits Program is made up of the following:

The Plan and its Exhibits, which include the SPD(s);

NRECA’s Group Benefits Program application; and

17

Any amendments and/or endorsements to the Plan.

Physical Exams

If a claim is submitted for insurance benefits other than life insurance benefits, MetLife has the right to ask the insured to be examined by a Physician(s) of MetLife’s choice as often as is reasonably necessary to process the claim. MetLife will pay the cost of such exam.

Autopsy

MetLife has the right to make a reasonable request for an autopsy where permitted by law. Any such request will set forth the reasons MetLife is requesting the autopsy.

State Life Insurance Notices

Notice For Residents of All States

LIFE INSURANCE BENEFITS WILL BE REDUCED IF AN ACCELERATED BENEFIT IS PAID DISCLOSURE: The Life Insurance accelerated benefit offered under this certificate is intended to qualify for favorable tax treatment under the Internal Revenue Code of 1986. If this benefit qualifies for such favorable tax treatment, the benefit will be excludable from your income and not subject to federal taxation. Tax laws relating to accelerated benefits are complex. You are advised to consult with a qualified tax advisor about circumstances under which you could receive an accelerated benefit excludable from income under federal law.

DISCLOSURE: Receipt of an accelerated benefit may affect your, your Spouse’s or your family’s eligibility for public assistance programs such as Medical Assistance (Medicaid), Aid to Families with Dependent Children (AFDC), Supplementary Social Security Income (SSI), and drug assistance programs. You are advised to consult with a qualified tax advisor and with social service agencies concerning how receipt of such payment will affect your, your Spouse’s and your family’s eligibility for public assistance.

Notices for Residents in Other States

If you reside in Arkansas, California, Georgia, Illinois, Massachusetts, Minnesota, Mississippi, New Mexico, North Carolina, Pennsylvania, Utah, Virginia, or Wisconsin – please visit cooperative.com for a copy of your applicable State Life Insurance Notice or ask your Benefits Administrator for a copy.

Chapter 9: Plan Information

Plan Name: The NRECA Group Benefits Program Plan Number: 501 Year Ends: December 31 Type of Plan: Retired Life Insurance Plan Effective Date: January 1, 2012

Underwritten by: Metropolitan Life Insurance Company 501 US Highway 22 P.O. Box 6891 Bridgewater, NJ 08807

Plan Sponsor: National Rural Electric Cooperative Association

18

4301 Wilson Boulevard Arlington, VA 22203-1860

Plan Sponsor Employer Identification Number: 53-0116145

The Insurance & Financial Services Department of the National Rural Electric Cooperative Association (NRECA) performs the general administrative duties. The names of persons who have the decision-making responsibilities are on file at the NRECA Insurance & Financial Services Department.

Plan Administrator: Senior Vice-President Insurance & Financial Services National Rural Electric Cooperative Association

4301 Wilson Boulevard Arlington, VA 22203-1860 Telephone number 703.907.5500

Plan Administrator Employer Identification Number: 54-2072724

In addition to the Senior Vice-President of the Insurance and Financial Services Department, the benefits administrator is the person with Plan Administrator responsibilities for your Employer:


Employer Identification Number: 43-0445644

The agent for service of process receives all legal notices on behalf of the Plan Sponsor regarding claims or suits filed with respect to the Plans.

Agent for service of process:

Senior Vice-President Insurance & Financial Services Department National Rural Electric Cooperative Association 4301 Wilson Boulevard Arlington, VA 22203-1860

In addition to the agent for service of legal process, service may also be made upon the Plan Trustee.

Plan Trustee, NRECA Group Benefits Trust:

State Street Bank and Trust Company 225 Franklin Street Boston, MA 02101

Claim Adjudicator: Metropolitan Life Insurance Company Group Life Claims P.O. Box 6100 Scranton, PA 18505-6100

19

Chapter 10: Administrative Information

Not a Contract of Employment

This Plan must not be construed as a contract of employment and does not give any Employee a right of continued employment. Nor may the Plan be construed as a guarantee of other benefits from your Employer.

Non-Assignment of Benefits

You cannot assign, pledge, borrow against or otherwise promise any benefit payable under the Plan before you receive it.

Right of Recovery of Overpayment

If it is later determined that you received an overpayment or a payment was made in error, you will be required to refund the overpayment to the Plan. The Plan has the right to recover overpayments as a result of, but not limited to those:

Due to fraud;

Due to any error the Plan makes in processing a claim; and

Benefits paid after the death of the Employee.

If you do not refund the overpayment, the Plan reserves the right to bring legal action against you to recover the overpayment and/or to offset future benefit payments until the overpayment is recouped. You will be notified if a mistake is found.

Amendment or Termination

This Plan may be amended or terminated at any time, for any reason, by action of the Plan Administrator or your Employer. This includes the right to change the cost of coverage. These changes may be made with or without advance notice to Plan participants. However, your rights to claim benefits for the period prior to the termination or amendment will not be affected if such benefit is payable under the Plan as in effect before the Plan is terminated or amended.

Severability

If any provision of this Plan is held invalid, the invalid provision does not affect the remaining parts of this Plan. The Plan is construed and enforced as if the invalid provision had never been included.

Additional Procedures

The Plan Administrator may promulgate any rules, regulations or procedures not covered by this Plan that may be necessary for the proper administration of this Plan.

Chapter 11: Federal Laws Impacting This Plan

Statement of ERISA Rights

Your Rights

As an Employee in the Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants shall be entitled to:

Receive Information About Your Plan and Benefits

20

You have the right to:

Examine, without charge, at the Plan Administrator’s office and at other specified locations, such as worksites, all documents governing the Plan, including insurance contracts, if any, and a copy of the latest annual report (Form 5500 series), if any, filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.

Obtain, upon request to the Plan Administrator, copies of documents governing the operation of the Plan, including insurance contracts and copies of the latest annual report (Form 5500 Series) and updated summary plan description (SPD). The Plan Administrator may make a reasonable charge for the copies.

Receive a summary of the Plan’s annual Form 5500, if any is required by ERISA to be prepared, in which case NRECA, as Plan Administrator, is required by law to furnish each participant with a copy of this summary annual report.

Duties of Plan Fiduciaries

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Employee benefit plan. The people who operate your Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your Employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit or exercising your rights under ERISA.

Enforce Your Rights

If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps that you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report (Form 5500), if any, from the Plan and do not receive them within 30 days, you may file suit in federal court. In such case, the court may require the Plan Administrator to provide the materials and pay you up to $110 per day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored in whole or in part, and if you have exhausted the claims procedures available to you under the Plan, you may file suit in a state or federal court.

If it should happen that Plan fiduciaries misuse the Plan’s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Please remember that you may not file a lawsuit in federal or state court to enforce your rights until you have exercised, and exhausted, all mandatory administrative claim and appeal rights described in the Plan and in this document. Any suit for benefits must be brought within one year from the date the final appeal determination was made.

Assistance with Your Questions

21

If you have any questions about your Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor (listed in your telephone directory) or contact the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

Chapter 12: Definitions

As used in this SPD, the terms listed below will have the meanings set forth below. When defined terms are used in this SPD, they will appear with initial capitalization. The plural use of a term defined in the singular will share the same meaning.

Beneficiary means the person(s) to whom MetLife will pay insurance as determined in accordance with Chapter 9.

Contributory Insurance means insurance for which the Employer requires you to pay any part of the premium.

Employer means the organization, association, cooperative, system, entity, etc., from which you receive a salary for performing your job responsibilities and through which you receive the benefits under the Plan.

Proof means Written evidence satisfactory to MetLife that a person has satisfied the conditions and requirements for any benefit described in this SPD. When a claim is made for any benefit described in this SPD, Proof must establish:

the nature and extent of the loss or condition;

MetLife’s obligation to pay the claim; and

the claimant’s right to receive payment.

Proof must be provided at the claimant’s expense.

Signed means any symbol or method executed or adopted by a person with the present intention to authenticate a record, which is on or transmitted by paper or electronic media which is acceptable to MetLife and consistent with applicable law.

Written or Writing means a record which is on or transmitted by paper or electronic media which is acceptable to MetLife and consistent with applicable law.